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Gu H, Shao B, Hu Y, Qian M, Tang S, Guo Q, Zhang Z, Yuan H, Yu H, Wang H. Epidemiological characteristics of traumatic spinal fractures among the elderly in China. Sci Rep 2024; 14:19170. [PMID: 39160209 PMCID: PMC11333744 DOI: 10.1038/s41598-024-69780-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 08/08/2024] [Indexed: 08/21/2024] Open
Abstract
The exploration of traumatic spinal fractures (TSFs) within the senior demographic has not been thoroughly scrutinized, particularly with respect to variations across genders, age groups, seasonal periods, and causative factors. This retrospective analysis aimed to dissect differences in the prevalence and characteristics of TSFs among the elderly, factoring in gender, age, seasonal timing, and causation. A retrospective analysis was conducted on the medical and imaging records of 1,415 patients, all aged 60 years or older, who were diagnosed with TSFs from 2013 to 2019. This study categorized the data by gender, age groups (60-70, 70-80, and 80 years or older), seasons, and the cause of injuries, including road traffic crashes (RTCs), falls from low heights (LHF), falls from high heights (HHF), and injuries incurred during everyday activities and agricultural labor (DFI). Male patients exhibited notably higher incidences of RTCs, high-height falls (HHFs), outdoor incidents, comas post-injury, fractures of the lower limbs (LLFs), pelvic fractures (PFs), rib fractures (RFs), intra-thoracic injuries (ITIs), intra-abdominal injuries (IAIs), cervical fractures, and spinal cord injuries (SCIs). With advancing age, there was a marked decline in occurrences of RTCs, HHFs, outdoor incidents, RFs, craniocerebral injuries (CCIs), ITIs, cervical fractures, and SCIs, while the incidences of DFIs, indoor incidents, and thoracic and lumbar (T + L) fractures notably increased. During autumn, LLF occurrences were significantly reduced, whereas the winter season saw an increase in thoracic fractures. Spring time was associated with a higher frequency of lumbar fractures and noncontiguous spinal fractures (NSFs). Significant distinctions were observed in the age distribution, injury circumstances, associated injuries, and SCIs between high-energy impacts (RTCs and HHFs) and low-energy traumas (LHFs and DFIs). In the elderly demographic, TSFs exhibited discernible distinctions based on gender, age, seasonal variations, and etiological factors, impacting the nature and circumstances of injuries, associated traumas, complications, fracture sites, and the occurrence of SCIs.
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Affiliation(s)
- Hongwen Gu
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA, Shenyang, 110016, Liaoning, China
| | - Bing Shao
- Department of Anaesthesia, General Hospital of Northern Theater Command of Chinese PLA, Shenyang, 110016, Liaoning, China
| | - Yin Hu
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA, Shenyang, 110016, Liaoning, China
| | - Mengran Qian
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA, Shenyang, 110016, Liaoning, China
| | - Shilei Tang
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA, Shenyang, 110016, Liaoning, China
| | - Qin Guo
- Department of Out-Patient, Xinqiao Hospital, the Army Medical University, Chongqing, 400037, China
| | - Zhihao Zhang
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA, Shenyang, 110016, Liaoning, China
| | - Hong Yuan
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA, Shenyang, 110016, Liaoning, China.
| | - Hailong Yu
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA, Shenyang, 110016, Liaoning, China.
| | - Hongwei Wang
- Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA, Shenyang, 110016, Liaoning, China.
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Karmali S, Saxena S, Richards O, Thompson W, McFaull SR, Pike I. What was the impact of COVID-19 restrictions on unintentional injuries, in Canada and globally? A scoping review investigating how lockdown measures impacted the global burden of unintentional injury. Front Public Health 2024; 12:1385452. [PMID: 38887259 PMCID: PMC11180821 DOI: 10.3389/fpubh.2024.1385452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/20/2024] [Indexed: 06/20/2024] Open
Abstract
Background Injuries are among the leading causes for hospitalizations and emergency department (ED) visits. COVID-19 restrictions ensured safety to Canadians, but also negatively impacted health outcomes, including increasing rates of certain injuries. These differences in trends have been reported internationally however the evidence is scattered and needs to be better understood to identify opportunities for public education and to prepare for future outbreaks. Objective A scoping review was conducted to synthesize evidence regarding the impact of COVID-19 restrictions on unintentional injuries in Canada, compared to other countries. Methods Studies investigating unintentional injuries among all ages during COVID-19 from any country, published in English between December 2019 and July 2021, were included. Intentional injuries and/or previous pandemics were excluded. Four databases were searched (MEDLINE, Embase, Web of Science, SPORTDiscus), and a gray literature search was also conducted. Results The search yielded 3,041 results, and 189 articles were selected for extraction. A total of 41 reports were included from the gray literature search. Final studies included research from: Europe (n = 85); North America (n = 44); Asia (n = 32); Oceania (n = 12); Africa (n = 8); South America (n = 4); and multi-country (n = 4). Most studies reported higher occurrence of injuries/trauma among males, and the average age across studies was 46 years. The following mechanisms of injury were reported on most frequently: motor vehicle collisions (MVCs; n = 134), falls (n = 104), sports/recreation (n = 65), non-motorized vehicle (n = 31), and occupational (n = 24). Injuries occurring at home (e.g., gardening, home improvement projects) increased, and injuries occurring at schools, workplaces, and public spaces decreased. Overall, decreases were observed in occupational injuries and those resulting from sport/recreation, pedestrian-related, and crush/trap incidents. Decreases were also seen in MVCs and burns, however the severity of injury from these causes increased during the pandemic period. Increases were observed in poisonings, non-motorized vehicle collisions, lacerations, drownings, trampoline injuries; and, foreign body ingestions. Implications Findings from this review can inform interventions and policies to identify gaps in public education, promote safety within the home, and decrease the negative impact of future stay-at-home measures on unintentional injury among Canadians and populations worldwide.
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Affiliation(s)
- Shazya Karmali
- BC Injury Research and Prevention Unit, BC Children’s Hospital Research Institute, Vancouver, BC, Canada
| | | | | | | | | | - Ian Pike
- BC Injury Research and Prevention Unit, BC Children’s Hospital Research Institute, Vancouver, BC, Canada
- Faculty of Medicine, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
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Ho YS, Giordano V, Mauffrey C, Giannoudis PV. Trends of impact factor contributors to the Injury Journal: A bibliometric analysis. Injury 2024; 55:111255. [PMID: 38042694 DOI: 10.1016/j.injury.2023.111255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/21/2023] [Accepted: 11/26/2023] [Indexed: 12/04/2023]
Abstract
PURPOSE This study aims to analyse papers concerning journal impact factors published in the Injury-International Journal of the Care of the Injured between 1997 and 2022. Through this analysis, the research offers valuable insights into the publication performance and contributors to the journal impact factor, encompassing papers, authors, institutions, and countries. METHODS Articles and reviews published in the Injury between 1995 and 2021 were examined using the Science Citation Index Expanded database. The study employed the journal impact factor contributing indicator to compare highly cited and high journal impact factor papers across various aspects, including papers, authors, institutions, and countries. RESULTS A notable correlation exists between prolific authors, institutions, and countries, alongside those who contribute to high journal impact factors. However, a less distinct connection was observed between highly cited papers/authors and high journal impact factor contributors. The Injury serves as a well-regarded international journal. Notably, editorial members of the journal play a substantial role, serving as model editors and contributing significantly to the journal's success. Out of the Top 25 IF contributing papers with the CN of 34 or more the following themes were noted to dominate: bone healing/tissue regeneration (40 %) of papers, covid-19 pandemic (24 %), polytrauma/coagulopathy (12 %) and infection (8 %). CONCLUSIONS Utilizing the journal impact factor to assess research performance at the individual, institutional, or national levels appears not to be the most appropriate method. The results show that highly cited authors did not hold the distinction of being the primary contributors to the IF. Analysis revealed a low significant relationship among the primary contributors to the IF, highly cited papers, and the most influential papers in 2022. A more effective indicator could involve considering the total number of citations a publication receives from its year of publication up to the end of the most recent year.
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Affiliation(s)
- Yuh-Shan Ho
- Trend Research Centre, Asia University, No. 500, Lioufeng Road, Taichung 41354, Taiwan
| | - Vincenzo Giordano
- Serviço de Ortopedia e Traumatologia Prof. Nova Monteiro, Hospital Municipal Miguel Couto, Rua Mario Ribeiro, 117/2° Andar, Gávea, Rio de Janeiro, RJ 22430‑160, Brazil
| | - Cyril Mauffrey
- Department of orthopedic surgery, physical medicine and rehabilitation, Denver Health Medical Center, University of Colorado, Denver, USA
| | - Peter V Giannoudis
- Trauma & Orthopaedic Surgery, School of Medicine, University of Leeds, UK; NIHR Leeds Biomedical Research Center, Chapel Allerton Hospital, Leeds, UK.
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Park H, Kang H, Yoon S, Jeong S, Lee S. The Effect of the COVID-19 Pandemic on Early Adolescent Fractures in the Republic of Korea. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1671. [PMID: 37763789 PMCID: PMC10537179 DOI: 10.3390/medicina59091671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/08/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: Restrictions on daily activities to slow down the propagation of COVID-19 have changed the epidemiological pattern of pediatric fractures in many countries. However, the effect of the pandemic on pediatric fractures has not been fully studied. In this study, we investigated the impact of COVID-19 on early adolescent fractures in Korea. Materials and methods: We conducted a retrospective follow-up on a nationwide cohort of Korean early adolescents born between 2006 and 2009. The prevalence and incidence of pediatric fractures and the frequency of surgical treatment were compared between two different eras. Results: The prevalence and incidence of fractures during the pandemic have both shown a significant decrease: prevalence reduced from 34,626 to 24,789 (p < 0.001), while incidence decreased from 29,804 to 18,898 (p < 0.001). Considering sex, the shift in fracture prevalence was statistically significant (p = 0.020), whereas the incidence was not (p = 0.862). The decline in both fracture prevalence and incidence exhibited significant variation across birth year groups (prevalence, p < 0.001; incidence, p < 0.001), with a more pronounced reduction observed in the older age groups. While the proportion of patients who required surgeries has increased, the mean frequency of surgical treatment per patient remained at a similar level (by prevalence, p = 0.181; by incidence, p = 0.735). The decline in both fracture prevalence and incidence has shown significant variation in relation to fracture sites (prevalence, p < 0.001; incidence, p < 0.001), with a decrease in distal limb fractures and an increase in forearm and axial body fractures. Conclusions: The pediatric fracture pattern in Korea has been notably influenced by the COVID-19 pandemic, warranting further investigation into causal factors. Our findings should help predict epidemiology in the post-pandemic period and thus aid policymaking and patient management.
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Affiliation(s)
- HyunSeo Park
- CHA University School of Medicine, 120 Hyeryong-ro, Pocheon-si 11160, Gyeonggi-do, Republic of Korea; (H.P.); (H.K.)
| | - Hogyeong Kang
- CHA University School of Medicine, 120 Hyeryong-ro, Pocheon-si 11160, Gyeonggi-do, Republic of Korea; (H.P.); (H.K.)
| | - Siyeong Yoon
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, 335 Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Republic of Korea; (S.Y.); (S.J.)
| | - Simho Jeong
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, 335 Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Republic of Korea; (S.Y.); (S.J.)
| | - Soonchul Lee
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, 335 Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Republic of Korea; (S.Y.); (S.J.)
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Muhammad H, Magetsari R, Rukmoyo T, Hasan M, Hidayat L, Triangga AF, Putro YA, Lanodiyu ZA, Rahayu BF, Kartika A, Sakti YM. Impacts of COVID-19 pandemic on pediatric fractures: a 4-year evaluation of epidemiology and delayed treatment from prepandemic to pandemic period at a tertiary referral hospital. Ann Med Surg (Lond) 2023; 85:4300-4306. [PMID: 37663680 PMCID: PMC10473331 DOI: 10.1097/ms9.0000000000001073] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/03/2023] [Indexed: 09/05/2023] Open
Abstract
Background Definitive fracture surgery should be performed as soon as the patient's condition allows. However, there may be some delays in the treatment during a pandemic. Objective This study aimed to investigate and compare the epidemiology and delays in pediatric fracture management during the pandemic and prepandemic periods in terms of how many cases were delayed, how long were the delays, and the causes for the delays of fracture treatment. Methods This comparative-retrospective study was conducted in a tertiary referral hospital in Yogyakarta, Indonesia. The authors included all patients who presented to the hospital from 1 December 2019 to 30 November 2021 (pandemic group period) and from 1 December 2017 to 30 November 2019 (prepandemic group period). The collected data included: patients' age and sex, fractured bone, fracture type, concurrent fracture, hospital stay duration, treatment, need for multidisciplinary treatment, interval from arrival to treatment, and reasons for delayed surgical treatment. The data were obtained from the patients' medical records. Results Results showed a decrease in the pediatric fracture cases during the 2 years pandemic period compared to the prepandemic period (75 vs. 135 cases). There was no significant difference in the evaluated parameters of demographic, fractured bone and type, hospital stay duration, treatment, other department involvement, and delayed surgical treatment for the fracture. The most common reason for the definitive surgical management delay was the need for medical condition improvements (n=63, 79.7%) and it was significantly associated with the need for multidisciplinary treatment approach (22.83 in isolated orthopedic cases vs. 87.5% in multidisciplinary cases; P=0.000). Conclusion There was a decrease in the pediatric fracture cases during the 2-year pandemic period compared to the prepandemic period. The delay in definitive surgical management was mainly due to the need for the medical condition improvements and it was associated with the need for a multidisciplinary treatment approach.
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Affiliation(s)
- Hilmi Muhammad
- Department of Surgery, Division of Orthopedics and Traumatology, Dr. Sardjito General Hospital, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Zhou S, Liu S, Wang Y, Li W, Wang J, Wang X, Wang S, Chen W, Lv H. Advances in the Study of Bionic Mineralized Collagen, PLGA, Magnesium Ionomer Materials, and Their Composite Scaffolds for Bone Defect Treatment. J Funct Biomater 2023; 14:406. [PMID: 37623651 PMCID: PMC10455784 DOI: 10.3390/jfb14080406] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/26/2023] Open
Abstract
The healing of bone defects after a fracture remains a key issue to be addressed. Globally, more than 20 million patients experience bone defects annually. Among all artificial bone repair materials that can aid healing, implantable scaffolds made from a mineralized collagen (MC) base have the strongest bionic properties. The MC/PLGA scaffold, created by adding Poly (lactic-co-glycolic acid) copolymer (PLGA) and magnesium metal to the MC substrate, plays a powerful role in promoting fracture healing because, on the one hand, it has good biocompatibility similar to that of MC; on the other hand, the addition of PLGA provides the scaffold with an interconnected porous structure, and the addition of magnesium allows the scaffold to perform anti-inflammatory, osteogenic, and angiogenic activities. Using the latest 3D printing technology for scaffold fabrication, it is possible to model the scaffold in advance according to the requirement and produce a therapeutic scaffold suitable for various bone-defect shapes with less time and effort, which can promote bone tissue healing and regeneration to the maximum extent. This study reviews the material selection and technical preparation of MC/PLGA scaffolds, and the progress of their research on bone defect treatment.
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Affiliation(s)
- Shuai Zhou
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang 050051, China; (S.Z.); (S.L.); (Y.W.); (W.L.)
- Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No. 139 Ziqiang Road, Shijiazhuang 050051, China
- NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang 050051, China
| | - Shihang Liu
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang 050051, China; (S.Z.); (S.L.); (Y.W.); (W.L.)
- Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No. 139 Ziqiang Road, Shijiazhuang 050051, China
- NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang 050051, China
| | - Yan Wang
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang 050051, China; (S.Z.); (S.L.); (Y.W.); (W.L.)
- Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No. 139 Ziqiang Road, Shijiazhuang 050051, China
- NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang 050051, China
| | - Wenjing Li
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang 050051, China; (S.Z.); (S.L.); (Y.W.); (W.L.)
- Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No. 139 Ziqiang Road, Shijiazhuang 050051, China
- NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang 050051, China
| | - Juan Wang
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang 050051, China; (S.Z.); (S.L.); (Y.W.); (W.L.)
- Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No. 139 Ziqiang Road, Shijiazhuang 050051, China
- NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang 050051, China
| | - Xiumei Wang
- State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, No. 30 Shuangqing Road, Beijing 100084, China
| | - Shuo Wang
- State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, No. 30 Shuangqing Road, Beijing 100084, China
| | - Wei Chen
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang 050051, China; (S.Z.); (S.L.); (Y.W.); (W.L.)
- Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No. 139 Ziqiang Road, Shijiazhuang 050051, China
- NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang 050051, China
| | - Hongzhi Lv
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang 050051, China; (S.Z.); (S.L.); (Y.W.); (W.L.)
- Key Laboratory of Biomechanics of Hebei Province, Orthopaedic Research Institution of Hebei Province, No. 139 Ziqiang Road, Shijiazhuang 050051, China
- NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang 050051, China
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Lv H, Li W, Wang Y, Chen W, Yan X, Yuwen P, Hou Z, Wang J, Zhang Y. Prediction model for tibial plateau fracture combined with meniscus injury. Front Surg 2023; 10:1095961. [PMID: 37396296 PMCID: PMC10312001 DOI: 10.3389/fsurg.2023.1095961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/05/2023] [Indexed: 07/04/2023] Open
Abstract
Purpose To investigate a prediction model of meniscus injury in patients with tibial plateau fracture. Methods This retrospective study enrolled patients with tibial plateau fractures who were treated in the Third Hospital of Hebei Medical University from January 1, 2015, to June 30, 2022. Patients were divided into a development cohort and a validation cohort based on the time-lapse validation method. Patients in each cohort were divided into a group with meniscus injury and a group without meniscus injury. Statistical analysis with Student's t-test for continuous variables and chi square test for categorical variables was performed for patients with and without meniscus injury in the development cohort. Multivariate logistic regression analysis was used to screen the risk factors of tibial plateau combined with meniscal injury, and a clinical prediction model was constructed. Model performance was measured by examining discrimination (Harrell's C-index), calibration (calibration plots), and utility [decision analysis curves (DCA)]. The model was validated internally using bootstrapping and externally by calculating their performance in a validation cohort. Results Five hundred patients (313 [62.6%] males, 187 [37.4%] females) with a mean age of 47.7 ± 13.8 years were eligible and were divided into development (n = 262) and validation (n = 238) cohorts. A total of 284 patients had meniscus injury, including 136 in the development cohort and 148 in the validation cohort We identified high-energy injuries as a risk factor (OR = 1.969, 95%CI 1.131-3.427). Compared with blood type A, patients with blood type B were more likely to experience tibial plateau fracture with meniscus injury (OR = 2.967, 95%CI 1.531-5.748), and office work was a protective factor (OR = 0.279, 95%CI 0.126-0.618). The C-index of the overall survival model was 0.687 (95% CI, 0.623-0.751). Similar C-indices were obtained for external validation [0.700(0.631-0.768)] and internal validation [0.639 (0.638-0.643)]. The model was adequately calibrated and its predictions correlated with the observed outcomes. The DCA curve showed that the model had the best clinical validity when the threshold probability was 0.40 and 0.82. Conclusions Patients with blood type B and high-energy injuries are more likely to have meniscal injury. This may help in clinical trial design and individual clinical decision-making.
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Affiliation(s)
| | | | | | | | | | | | | | - Juan Wang
- Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, ShijiazhuangChina
| | - Yingze Zhang
- Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, ShijiazhuangChina
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VON-Bahten LC, Zvicker AL, Silva AADA, Salviato BZ, Teixeira HM, Ando PK, Bernardelli RS. Influence of the COVID-19 pandemic on the epidemiological profile of the initial care of victims of falls. Rev Col Bras Cir 2023; 50:e20233422. [PMID: 36921132 PMCID: PMC10519699 DOI: 10.1590/0100-6991e-20233422-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/17/2022] [Indexed: 03/12/2023] Open
Abstract
OBJECTIVE to assess the epidemiological profile of trauma patients from fall from the same level (FSL) and fall from an elevated level (FEL) during the COVID-19 pandemic, and to compare it with data from different levels of restriction (flags) and data prior to the pandemic. METHOD a cross-sectional study with a probability sample of the medical records of patients aged 18 years or older admitted to the emergency room due to falls, from June 2020 to May 2021. Epidemiological data, such as sex, age and injuries were analyzed, as well the current level of restriction. The three restriction periods were compared between then and the proportion of admissions due to falls was compared with the period from December 2016 to February 2018. RESULTS a total of 296 admissions were evaluated, 69.9% were victims of FSL and 30.1% of FEL. The mean age was 57.6 years, and 45.6% were over 60 years old. Admissions among men predominated, and 40.2% of patients required hospitalization. During the red flag period, there were proportionally more injuries to the head and neck (p=0.016), injuries to extremities (p=0.015) and neurological trauma (p<0.001). An average of 6.1, 6.3 and 5.2 admissions per day was obtained during the yellow, orange and red flag, respectively. There was a relative increase in falls when compared to the pre-pandemic period. CONCLUSIONS there was an absolute reduction in admissions of victims of falls in midst of the most restrictive period during the pandemic. However, when compared to pre-pandemic data, there was a relative increase in falls.
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Affiliation(s)
- Luiz Carlos VON-Bahten
- - Hospital Universitário Cajuru, Liga Acadêmica do Trauma (LATHUC) - Curitiba - PR - Brasil
- - Universidade Federal do Paraná, Departamento de Clínica Cirúrgica - Curitiba - PR - Brasil
- - Pontifícia Universidade Católica do Paraná, Escola de Medicina e Ciências da Vida - Departamento de Clínica Cirúrgica - Curitiba - PR - Brasil
| | - Aliana Lunardi Zvicker
- - Hospital Universitário Cajuru, Liga Acadêmica do Trauma (LATHUC) - Curitiba - PR - Brasil
| | - Angel Adriany DA Silva
- - Hospital Universitário Cajuru, Liga Acadêmica do Trauma (LATHUC) - Curitiba - PR - Brasil
| | | | - Heloísa Moro Teixeira
- - Hospital Universitário Cajuru, Liga Acadêmica do Trauma (LATHUC) - Curitiba - PR - Brasil
| | - Paula Kaori Ando
- - Hospital Universitário Cajuru, Liga Acadêmica do Trauma (LATHUC) - Curitiba - PR - Brasil
| | - Rafaella Stradiotto Bernardelli
- - Pontifícia Universidade Católica do Paraná, Escola de Medicina e Ciências da Vida - Departamento de Bioestatística - Curitiba - PR - Brasil
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Runtz A, Sleiman L, Dabert A, Obert L, Garbuio P, Pluvy I, Loisel F. [Has the COVID lockdown altered the incidence and management of fragility fractures in older adults? Case-control study at a French University Hospital]. REVUE DE CHIRURGIE ORTHOPEDIQUE ET TRAUMATOLOGIQUE 2023; 109:24-29. [PMID: 36268009 PMCID: PMC9558091 DOI: 10.1016/j.rcot.2022.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 09/29/2021] [Indexed: 11/24/2022]
Abstract
Introduction En France, un confinement national lié à la pandémie de COVID-19 a été décrété du 17 mars au 11 mai 2020, bouleversant nos pratiques professionnelles et organisationnelles. Nous nous sommes intéressés aux conséquences du confinement sur les fractures de fragilité chez les sujets de 65 ans et plus. L’objectif principal était d’évaluer l’incidence des fractures de fragilité périphériques et du bassin pendant la période de confinement. Les objectifs secondaires étaient de réaliser une analyse épidémiologique des fractures, des traitements et des données d’hospitalisation. Hypothèse L’hypothèse principale était que le nombre de fractures de fragilité périphériques et du bassin avait diminué pendant le confinement, comparativement à une période non confinée. Matériel et méthodes Nous avons recueilli rétrospectivement les données épidémiologiques (âge, sexe), cliniques (types de fractures, traitements) et d’hospitalisation des patients de plus de 65 ans consultant aux urgences traumatologiques pour une fracture périphérique et/ou du bassin, du 17 mars au 11 mai des années 2019 et 2020. Résultats Cent quatre-vingt-douze patients étaient inclus en 2019 contre 157 en 2020. L’âge moyen et le sex-ratio n’étaient statistiquement pas différents. Le nombre de fractures de fragilité périphériques et du bassin a baissé de 16,3 %. Le taux de prise en charge chirurgicale était comparable (46,3 % en 2019 ; 50,9 % en 2020 [p = 0,47]). Le nombre de fractures du fémur proximal a diminué de 20,6 %. Le délai préopératoire moyen de ces fractures était plus court en 2020 (p = 0,02) tandis que la durée moyenne d’hospitalisation était inchangée (p = 0,72). Le taux de mortalité des patients hospitalisés pour des fractures de fragilité n’augmentait pas de manière significative (p = 0,51). Discussion Nous avons observé une diminution des fractures de fragilité périphériques et du bassin chez les patients de plus de 65 ans durant le confinement. Afin d’assurer notre mission de prise en charge optimale des fractures du fémur proximal, une réorganisation globale du bloc opératoire a été nécessaire. Le maintien d’un plateau technique fonctionnel malgré cette situation de crise a été fondamental pour poursuivre la prise en charge de ces fractures et ainsi éviter une surmortalité significative. Niveau de preuve III, étude cas-témoin.
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Affiliation(s)
- Adrien Runtz
- Service d’orthopédie, traumatologie, chirurgie plastique et assistance main, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25000 Besançon, France,Auteur correspondant
| | - Loïc Sleiman
- Service d’orthopédie, traumatologie, chirurgie plastique et assistance main, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25000 Besançon, France
| | - Alizé Dabert
- Service d’orthopédie, traumatologie, chirurgie plastique et assistance main, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25000 Besançon, France
| | - Laurent Obert
- Service d’orthopédie, traumatologie, chirurgie plastique et assistance main, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25000 Besançon, France,Laboratoire de nanomédecine, imagerie et thérapeutique EA4662, université Bourgogne Franche-Comté, 25000 Besançon, France
| | - Patrick Garbuio
- Service d’orthopédie, traumatologie, chirurgie plastique et assistance main, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25000 Besançon, France,Laboratoire de nanomédecine, imagerie et thérapeutique EA4662, université Bourgogne Franche-Comté, 25000 Besançon, France
| | - Isabelle Pluvy
- Service d’orthopédie, traumatologie, chirurgie plastique et assistance main, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25000 Besançon, France,Laboratoire de nanomédecine, imagerie et thérapeutique EA4662, université Bourgogne Franche-Comté, 25000 Besançon, France
| | - François Loisel
- Service d’orthopédie, traumatologie, chirurgie plastique et assistance main, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25000 Besançon, France,Laboratoire de nanomédecine, imagerie et thérapeutique EA4662, université Bourgogne Franche-Comté, 25000 Besançon, France
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Runtz A, Sleiman L, Dabert A, Obert L, Garbuio P, Pluvy I, Loisel F. Has the COVID lockdown altered the incidence and management of fragility fractures in older adults? Case-control study at a French University Hospital. Orthop Traumatol Surg Res 2023; 109:103419. [PMID: 36167250 PMCID: PMC9508702 DOI: 10.1016/j.otsr.2022.103419] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 08/29/2021] [Accepted: 09/29/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION In France, a national lockdown related to the COVID-19 pandemic was imposed from March 17 to May 11, 2020, drastically changing our professional and organizational practices. We were interested on the impact of the lockdown on fragility fractures in older adults (65 years and older). The primary objective of this study was to evaluate the incidence of peripheral and pelvic fragility fractures during the lockdown. The secondary objectives were to carry out an epidemiological analysis of the fractures, treatments and hospitalization data. HYPOTHESIS The main hypothesis was that the number of peripheral and pelvic fragility fractures was lower during the lockdown in 2020 than in the same (non-lockdown) period in 2019. MATERIALS AND METHODS We retrospectively collected epidemiological (age, sex), clinical (type of fracture, treatment) and hospitalization data from patients 65 years and older who came to the emergency room because of a peripheral and/or pelvic fracture between March 17 and May 11 of the years 2019 and 2020. RESULTS We included 192 patients in 2019 and 157 patients in 2020. The mean age and sex ratio were not statistically different. The number of peripheral and/or pelvic fragility fractures decreased by 16%. The share of patients treated surgically was similar in both years (46% in 2019; 51% in 2020 (p=0.47)). The number of proximal femur fractures dropped by 21%. The mean time to surgery for these fractures was shorter in 2020 (p=0.02) although the mean length of hospital stay was unchanged (p=0.72) The mortality rate of patients hospitalized for fragility fractures did not increase significantly (p=0.51). DISCUSSION We observed a reduction in the number of peripheral and pelvic fragility fractures in patients 65 years and older during the lockdown. To ensure that we met our goals of optimal care for proximal femur fractures, a general reorganization of the operating room was necessary. The continued availability of fully functional technical facilities despite this health crisis was crucial to being able to treat these fractures and to prevent increased mortality. LEVEL OF EVIDENCE III, case-control study.
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Affiliation(s)
- Adrien Runtz
- Service d’orthopédie, traumatologie, chirurgie plastique et assistance main, CHU de Besançon, 25000 Besançon, France,Corresponding author
| | - Loïc Sleiman
- Service d’orthopédie, traumatologie, chirurgie plastique et assistance main, CHU de Besançon, 25000 Besançon, France
| | - Alizé Dabert
- Service d’orthopédie, traumatologie, chirurgie plastique et assistance main, CHU de Besançon, 25000 Besançon, France
| | - Laurent Obert
- Service d’orthopédie, traumatologie, chirurgie plastique et assistance main, CHU de Besançon, 25000 Besançon, France,Laboratoire de nanomédecine, imagerie et thérapeutique EA4662, université Bourgogne Franche-Comté, 25000 Besançon, France
| | - Patrick Garbuio
- Service d’orthopédie, traumatologie, chirurgie plastique et assistance main, CHU de Besançon, 25000 Besançon, France,Laboratoire de nanomédecine, imagerie et thérapeutique EA4662, université Bourgogne Franche-Comté, 25000 Besançon, France
| | - Isabelle Pluvy
- Service d’orthopédie, traumatologie, chirurgie plastique et assistance main, CHU de Besançon, 25000 Besançon, France,Laboratoire de nanomédecine, imagerie et thérapeutique EA4662, université Bourgogne Franche-Comté, 25000 Besançon, France
| | - François Loisel
- Service d’orthopédie, traumatologie, chirurgie plastique et assistance main, CHU de Besançon, 25000 Besançon, France,Laboratoire de nanomédecine, imagerie et thérapeutique EA4662, université Bourgogne Franche-Comté, 25000 Besançon, France
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The impact of confinement on orthopaedic and trauma surgical activity. Orthop Traumatol Surg Res 2023; 109:103113. [PMID: 34653645 DOI: 10.1016/j.otsr.2021.103113] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/09/2021] [Accepted: 05/14/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION On the 16th of March 2020, in the face of a health emergency declared in France, the government imposed containment measures whose impact on orthopaedic and trauma surgery remains to be demonstrated. The hypothesis of this study was that confinement reduced orthopaedic and trauma surgical activity. The main objective was to assess orthopaedic and trauma surgical activity during confinement and to compare it to the activity outside confinement. MATERIALS AND METHODS This was a retrospective, monocentric, observational and comparative study of a continuous cohort of patients included during the confinement period of March 16th to May 11th, 2020. This cohort was retrospectively compared to a group of patients over the same non-confinement period in the previous year, from March 16th to May 11th, 2019. The primary outcome measured was the incidence rate of surgical activity in 2020 versus 2019 over an identical period. The secondary outcome was the analysis of the trauma identified. RESULTS The number of patients operated on was significantly reduced during confinement: 194 patients were included in 2020, i.e. an incidence of 57 per 100,000 inhabitants against 772 patients included in 2019, i.e. an incidence of 227 per 100,000 inhabitants; p<0.001. Planned orthopaedic surgery decreased from an incidence rate of 147 in 2019 to 5 in 2020 per 100,000 inhabitants (p<0.001). Trauma surgery decreased from an incidence rate of 80 in 2019 to 50 in 2020 per 100,000 inhabitants (p: NS). We found a significant increase in patients over 65years of age during confinement, 70% compared to 61% in 2019; p=0.04. The rate of femoral neck fractures was significantly increased during confinement, 48.5% compared to 39.3% in 2019; p=0.03. Degenerative surgery was significantly reduced during confinement (p<0.001). DISCUSSION This study shows that the surgical activity of orthopaedics and trauma was significantly reduced by confinement, with a difference in incidence of 170 per 100,000 inhabitants, thus confirming the hypothesis of the authors. This decrease is due to both the cessation of planned orthopaedics and the 40% decrease in the number of trauma patients. During confinement, the percentage of patients over the age of 65 with a fracture increased significantly. CONCLUSION Confinement had a significant impact on orthopaedic and trauma surgical activity. LEVEL OF EVIDENCE III; comparative and retrospective.
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Troiano E, De Sensi AG, Zanasi F, Facchini A, De Marco G, Colasanti GB, Mondanelli N, Giannotti S. Impact of COVID-19 Pandemic on Treatment and Outcome of Fragility Hip Fractures In Non-COVID Patients: Comparison Between the Lockdown Period, a Historical Series and the "Pandemic Normality" in a Single Institution. Geriatr Orthop Surg Rehabil 2023; 14:21514593231152420. [PMID: 36950185 PMCID: PMC10026085 DOI: 10.1177/21514593231152420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
Introduction The COVID-19 pandemic has affected and is still deeply affecting all aspects of public life. World governments have been forced to enact restrictive measures to stem the contagion which have led to a decrease in the movement of people within national territory and to a redirection of health care resources with a suspension of non-urgent procedures. In Italy, a lockdown was imposed from March 9th to May 3rd, 2020. As a result, a significant reduction in the overall operative volume of orthopedic trauma was expected, but it was not possible to predict a similar trend regarding fragility fractures of the proximal femur in the elderly. Methods The aim of this paper was to examine the impact of COVID-19 on the operating volume for trauma surgeries and to determine how the pandemic affected the management of fragility hip fractures (FHFs) in non-COVID patients at a single Institution. Results The first result was a statistically significant reduction in the overall operative volume of orthopedic trauma during the period of the first lockdown and an increase in the mean age of patients undergoing surgery, as expected. As regard to the second aim, the incidence of FHFs remained almost unchanged during the periods analysed. The population examined were superimposable in terms of demographics, comorbidities, type of fracture, peri-operative complications, percentage of operations performed within 48 hours from hospitalization and 1-year outcome. Discussion Our results are in line with those already present in the Literature. Conclusions Our study revealed a significant impact of the restrictive anti-contagion measures on the overall orthopedic surgical volume, but, at the same time, we could affirm that the pandemic did not affect the management of FHFs in non-COVID patients, and their results.
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Affiliation(s)
- Elisa Troiano
- Department of Medicine Surgery and
Neurosciences, University of Siena, Siena, Italy
- Section of Orthopedics, Azienda Ospedaliero-Universitaria
Senese, Siena, Italy
| | - Alice Giulia De Sensi
- Department of Medicine Surgery and
Neurosciences, University of Siena, Siena, Italy
- Section of Orthopedics, Azienda Ospedaliero-Universitaria
Senese, Siena, Italy
| | - Francesco Zanasi
- Department of Medicine Surgery and
Neurosciences, University of Siena, Siena, Italy
| | - Andrea Facchini
- Azienda USL di Reggio Emilia, Arcispedale Santa Maria
Nuova, Reggio Emilia, Italy
| | - Giulia De Marco
- Department of Medicine Surgery and
Neurosciences, University of Siena, Siena, Italy
| | - Giovanni Battista Colasanti
- Department of Medicine Surgery and
Neurosciences, University of Siena, Siena, Italy
- Section of Orthopedics, Azienda Ospedaliero-Universitaria
Senese, Siena, Italy
| | - Nicola Mondanelli
- Department of Medicine Surgery and
Neurosciences, University of Siena, Siena, Italy
- Section of Orthopedics, Azienda Ospedaliero-Universitaria
Senese, Siena, Italy
- Nicola Mondanelli, Department of Medicine
Surgery and Neurosciences, University of Siena; and Section of Orthopedics,
Azienda Ospedaliero-Universitaria Senese, Viale Mario Bracci 16, Siena 53100,
Italy.
| | - Stefano Giannotti
- Department of Medicine Surgery and
Neurosciences, University of Siena, Siena, Italy
- Section of Orthopedics, Azienda Ospedaliero-Universitaria
Senese, Siena, Italy
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Huang BX, Wang YH, Wang HB, Wang C, Jin FF, Li J, Gan LX, Shi Y, Jiang BG, Zhang DY. Epidemiology and the economic burden of traumatic fractures in China: A population-based study. Front Endocrinol (Lausanne) 2023; 14:1104202. [PMID: 36761191 PMCID: PMC9902367 DOI: 10.3389/fendo.2023.1104202] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/12/2023] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES National data on the admission rate, distribution, in-hospital mortality, and economic burden of traumatic fractures in China is unclear. We aimed to conduct a cross-sectional population-based study to determine such above data at the national level in China. METHODS A national administrative database was used to review all traumatic fracture hospitalizations in China during 2020, from which a total of 2,025,169 inpatients with traumatic fractures was retrieved. Admission rates and in-hospital mortality rates stratified by age, sex, and region were calculated. The causes of traumatic fracture and economic burden were described. RESULTS The admission rate of traumatic fractures of all China population in 2020 was 1.437‰. The admission rate increased with age and varied with genders and causes of injuries. Falls are the leading cause of traumatic fracture hospitalization, followed by road traffic injuries. The most common diagnoses were femoral neck fractures, with a number of 138,377. The in-hospital mortality was 1.209‰. Road traffic injuries led to the highest in-hospital mortality. The median length of stay was 10 days, with the median hospitalization cost of ¥20,900 (about $3,056). CONCLUSION Traumatic fractures are concerning conditions with a high admission rate and in-hospital mortality in China, which are mainly caused by falls and road traffic injuries. The government should implement more public health policies to enhance the health of the elderly and improve transportation safety to prevent traumatic fractures.
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Affiliation(s)
- Bo-xuan Huang
- Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing, China
- Key Laboratory of Trauma and Neural Regeneration (Peking University), Ministry of Education, Beijing, China
- National Center for Trauma Medicine, Beijing, China
| | - Yan-hua Wang
- Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing, China
- Key Laboratory of Trauma and Neural Regeneration (Peking University), Ministry of Education, Beijing, China
- National Center for Trauma Medicine, Beijing, China
| | - Hai-bo Wang
- Clinical Trial Unit, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Chu Wang
- Key Laboratory of Trauma and Neural Regeneration (Peking University), Ministry of Education, Beijing, China
- National Center for Trauma Medicine, Beijing, China
- Trauma Medicine Center, Peking University People’s Hospital, Beijing, China
| | - Fei-fei Jin
- National Center for Trauma Medicine, Beijing, China
| | - Jing Li
- National Center for Trauma Medicine, Beijing, China
| | - Lan-xia Gan
- China Standard Medical Information Research Center, Shenzhen, China
| | - Ying Shi
- China Standard Medical Information Research Center, Shenzhen, China
| | - Bao-guo Jiang
- Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing, China
- Key Laboratory of Trauma and Neural Regeneration (Peking University), Ministry of Education, Beijing, China
- National Center for Trauma Medicine, Beijing, China
- Trauma Medicine Center, Peking University People’s Hospital, Beijing, China
- *Correspondence: Bao-guo Jiang, ; Dian-ying Zhang,
| | - Dian-ying Zhang
- Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing, China
- Key Laboratory of Trauma and Neural Regeneration (Peking University), Ministry of Education, Beijing, China
- National Center for Trauma Medicine, Beijing, China
- *Correspondence: Bao-guo Jiang, ; Dian-ying Zhang,
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VON-BAHTEN LUIZCARLOS, ZVICKER ALIANALUNARDI, SILVA ANGELADRIANYDA, SALVIATO BEATRIZZANUTTO, TEIXEIRA HELOÍSAMORO, ANDO PAULAKAORI, BERNARDELLI RAFAELLASTRADIOTTO. Influência da pandemia da COVID-19 no perfil epidemiológico do atendimento inicial de pacientes vítimas de quedas. Rev Col Bras Cir 2023. [DOI: 10.1590/0100-6991e-20233422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
RESUMO Objetivo: avaliar o perfil epidemiológico do trauma por quedas de mesmo nível (QMN) e quedas de nível elevado (QNE) durante a pandemia da COVID-19, realizar a comparação dos dados entre os níveis de restrição (bandeiras) e comparar com dados prévios à pandemia. Método: estudo transversal com amostragem probabilística de prontuários de pacientes com 18 anos ou mais admitidos na sala de emergência devido a quedas de junho de 2020 a maio de 2021. Foram avaliados dados epidemiológicos, como sexo, idade e lesões resultantes, além da bandeira vigente. Os três períodos de restrição foram comparados entre si e a proporção de atendimentos por quedas foi comparada com o período de dezembro de 2016 a fevereiro de 2018. Resultados: avaliou-se 296 atendimentos, sendo 69,9% vítimas de QMN e 30,1% de QNE. A média de idade foi 57,6 anos, sendo que 45,6% apresentavam idade superior a 60 anos. Sexo masculino predominou e 40,2% dos pacientes necessitaram internamento hospitalar. Durante a bandeira vermelha proporcionalmente ocorreram mais lesões em cabeça e pescoço (p=0,016), trauma em extremidades (p=0,015) e neurológico (p<0,001). Obteve-se uma média de 6,1, 6,3 e 5,2 atendimentos/dia durante a bandeira amarela, laranja e vermelha respectivamente. Ocorreu um aumento significativo da ocorrência de quedas quando comparado ao período prévio à pandemia. Conclusões: durante o período pandêmico, verificou-se uma redução absoluta de atendimentos de vítimas de quedas na bandeira mais restritiva. Porém, quando comparado ao período pré-pandêmico, verifica-se um aumento significativo das quedas.
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Affiliation(s)
- LUIZ CARLOS VON-BAHTEN
- Hospital Universitário Cajuru, Brasil; Universidade Federal do Paraná, Brazil; Pontifícia Universidade Católica do Paraná, Brazil
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Impact of the SARS-CoV-2 Outbreak on the Epidemiology and Treatment Outcomes of Fractures of the Proximal Femur in Kazakhstan. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2022. [DOI: 10.2478/sjecr-2022-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Abstract
The study aimed to assess the impact of isolation and quarantine on the frequency of registration and the treatment of fractures of the proximal femur in Kazakhstan in the context of the COVID-19 pandemic in 2020 (compared to the pre-pandemic period). This retrospective observational comparative study included all primary patients with injuries (the code S72) in the period 2019-2020 according to the national register.
In 2020, the number of S72 fractures was 6.6 % higher compared to 2019. In comparison with 2019, in 2020 the number of beddays of patients was reduced to 7.1±3.8 days (p≤0.001). Both in 2019 and in 2020, the number of women predominated among all patients (p ≤ 0.05). The frequency of conservative treatment in 2020 compared to 2019 was increased from 26.6% to 35.6%, while the surgical procedure for internal fixation was reduced to 34.2% in 2020. In 2020, the highest number of cases among women with S72 fractures cases were recorded in the age groups 60-74 years and 75-90 years. In 2019 in female patients (42%) with S72 cases were registered in the age group 75-90 years.
The incidence of fractures of the proximal femur did not change significantly in 2020 compared to 2019. However, the number of conservative treatment methods has increased along with the decrease in the frequency of surgical interventions. We observed the growth of the frequency of non-surgical treatment methods in 2020 that might impose the possible risks of mortality of these patients in the long term after conservative treatment.
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Silva AADA, Ströher GR, Teixeira HM, Cordeiro MVG, Olandoski M, VON-Bahten LC. Impact of the COVID-19 pandemic on the epidemiology of traffic accidents: a cross-sectional study. Rev Col Bras Cir 2022; 49:e20223364. [PMID: 36515331 PMCID: PMC10578847 DOI: 10.1590/0100-6991e-20223364-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/20/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE to assess the epidemiological profile of traffic accident victims in the setting of the Coronavirus Disease 2019 (COVID-19) pandemic and analyze the admissions throughout the different levels of restriction (flags), as well as compare the results with the pre-pandemic period. METHODS a cross-sectional study was performed, with probability sampling, in a trauma center in Brazil. Medical records of patients involved in traffic accidents from June 2020 to May 2021 were evaluated. Aside from epidemiological characteristics, variables such as the current flag, the trauma mechanism, the resulting injuries, and the Revised Trauma Score (RTS) were also considered. Data were compared between three different flag periods and the proportion of consultations during the pandemic was compared with that from pre-pandemic time (December 2016 to February 2018). RESULTS it was observed that 62.2% of the patients were victims of motorcycle accidents, 77.5% were male, and the mean age was 33 ± 12.4 years. The mean and median RTS were 7.5 and 7.8, respectively. Statistical difference was stated when comparing the number of visits per day between the yellow and red flags (p=0.001) and orange and red flags (p=0.016). A significantly lower number of consultations for traffic accidents was observed in the pandemic when compared to the pre-pandemic period. CONCLUSIONS the epidemiological profile of the study consisted mostly of young men who were victims of motorcycle accidents. There was a lower incidence of admissions during red flag periods and a lower proportion of consultations throughout the survey when compared to the pre-pandemic period.
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Affiliation(s)
- Angel Adriany DA Silva
- - Hospital Universitário Cajuru, Liga Acadêmica do Trauma (LATHUC) - Curitiba - PR - Brasil
| | | | - Heloísa Moro Teixeira
- - Hospital Universitário Cajuru, Liga Acadêmica do Trauma (LATHUC) - Curitiba - PR - Brasil
| | | | - Marcia Olandoski
- - Pontifícia Universidade Católica do Paraná, Escola de Medicina e Ciências da Vida, Departamento de Bioestatística - Curitiba - PR - Brasil
| | - Luiz Carlos VON-Bahten
- - Hospital Universitário Cajuru, Liga Acadêmica do Trauma (LATHUC) - Curitiba - PR - Brasil
- - Universidade Federal do Paraná, Departamento de Clínica Cirúrgica - Curitiba - PR - Brasil
- - Pontifícia Universidade Católica do Paraná, Escola de Medicina e Ciências da Vida, Departamento de Clínica Cirúrgica - Curitiba - PR - Brasil
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Bharat A, Verma V, Afaque SF, Raikwar A, Chand S, Singh A. Effect of COVID 19 pandemic on time to care, use of ambulance, admission characteristics, demography, injury characteristics, management and outcome of Paediatric Orthopaedic trauma patients admitted to the trauma centre. INDIAN JOURNAL OF COMMUNITY HEALTH 2022. [DOI: 10.47203/ijch.2022.v34i03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background: Lockdown imposed to limit the spread of COVID 19 may have had a significant effect on the time to care, demography, injury causation, injury characteristics, volume and nature of admission, management and outcome of paediatric orthopaedic trauma patients. Objective: To document the effect of lockdown on the time to care at KGMU, use of ambulance, volume and type of admissions, demography, injury causation, injury characteristics, management and outcome of paediatric orthopaedic trauma patients. Methods:. This record review compared age, sex, type of admission, mechanism of injury, injury characteristics, type of treatment, vehicle used for transport, and outcome among patients admitted in pre-lockdown, lockdown and post lockdown. Results: Lockdown was associated with decrease in the number of cases (p<0.01), increase in the time since injury to reception (p<0.040), a rise in the share of referred admission (p<0.040), time since reception at KGMU, time to definitive care (p<0.001), high energy falls (p<0.001), injuries at home (p<0.001), higher ISS (p<0.001), non operative treatment (p=0.038) and greater use of ambulance (p=0.003). Conclusion: Lockdown resulted in a significant change in the causation and management of injury, significant delays in timeliness of care, reduction in the volume of admissions, an increase in injury severity and share of referral admissions.
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18
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Liu G, Yang M, Li N, Li S, Zhu S, Wu X. The Effects of COVID-19 on Geriatric Hip Fracture Management and 1-Year Mortality in Beijing. Orthop Surg 2022; 14:2527-2534. [PMID: 36029040 PMCID: PMC9531070 DOI: 10.1111/os.13464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives Concerns about the coronavirus disease 2019 (COVID‐19) pandemic resulted in unprecedented challenges to the management of geriatric hip fractures. We aimed to evaluate the effects of the COVID‐19 surge on the time to surgery and 1 year mortality in geriatric patients with hip fracture at a large, urban Level 1 trauma center in Beijing, and to guide the management of geriatric hip fracture patients throughout the COVID‐19 pandemic. Methods This single‐center retrospective study included consecutive patients aged ≥65 years and injured 3 weeks prior to admission. Demographic and surgical data were collected between January 20 and May 31, 2020, and from the same period in 2019. Mortality data and functional status were collected at follow‐up of 1‐year after surgery. The primary outcomes were time to surgery and 1 year mortality. Results There were no significant differences in sex, fracture type, and surgical pattern between the 2020 (n = 261) and 2019 time‐matched (n = 307) cohorts. The time from admission to surgery was significantly delayed in the 2020 cohort compared with that in the 2019 cohort (48.9 h vs 20.5 h, p < 0.001). Fewer patients underwent surgery within 48 h in the 2020 cohort (65.5% vs 87.6%, p < 0.001). Surgical delay was also associated with an increased risk of inpatient complications (30.2% vs 20.8%, p = 0.010), however there was no significant difference in the 1‐year mortality rate, nor between pre‐injury and 1 year follow‐up mobility as assessed by Parker score. Only approximately half of the patients in both groups completely returned to their pre‐injury mobility levels. Conclusions The COVID‐19 pandemic has significantly increased the surgery waiting time for geriatric patients with hip fractures, which resulted in increased inpatient complications without a higher mortality rate within 1 year. This reinforces the importance of maintaining timely and protocolized care for geriatric hip fractures throughout any subsequent waves of the pandemic.
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Affiliation(s)
- Gang Liu
- Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Peking University Fourth School of Clinical Medicine, Beijing, China
| | - Minghui Yang
- Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Peking University Fourth School of Clinical Medicine, Beijing, China
| | - Ning Li
- Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Peking University Fourth School of Clinical Medicine, Beijing, China
| | - Shaoliang Li
- Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Peking University Fourth School of Clinical Medicine, Beijing, China
| | - Shiwen Zhu
- Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Peking University Fourth School of Clinical Medicine, Beijing, China
| | - Xinbao Wu
- Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Peking University Fourth School of Clinical Medicine, Beijing, China
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19
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Ma Y, Qiu S, Zhou R. Osteoporosis in Patients With Respiratory Diseases. Front Physiol 2022; 13:939253. [PMID: 35903070 PMCID: PMC9315364 DOI: 10.3389/fphys.2022.939253] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
Climate change, environmental pollution, and virus epidemics have sharply increased the number of patients suffering from respiratory diseases in recent years. Prolonged periods of illness and drug use increase the occurrence of complications in these patients. Osteoporosis is the common bone metabolism disease with respiratory disturbance, which affects prognosis and increases mortality of patients. The problem of osteoporosis in patients with respiratory diseases needs more attention. In this review, we concluded the characteristics of osteoporosis in some respiratory diseases including COPD, asthma, COVID-19, tuberculosis, and lung cancer. We revealed that hypoxia was the common pathogenesis of osteoporosis secondary to respiratory diseases, with malnutrition and corticosteroid abuse driving the progression of osteoporosis. Hypoxia-induced ROS accumulation and activated HIF-1α lead to attenuated osteogenesis and enhanced osteoclastogenesis in patients with respiratory diseases. Tuberculosis and cancer also invaded bone tissue and reduced bone strength by direct infiltration. For the treatment of osteoporosis in respiratory patients, oral-optimized bisphosphonates were the best treatment modality. Vitamin D was a necessary supplement, both for calcium absorption in osteogenesis and for improvement of respiratory lesions. Reasonable adjustment of the dose and course of corticosteroids according to the etiology and condition of patients is beneficial to prevent the occurrence and development of osteoporosis. Additionally, HIF-1α was a potential target for the treatment of osteoporosis in respiratory patients, which could be activated under hypoxia condition and involved in the process of bone remodeling.
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Affiliation(s)
- Yue Ma
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shui Qiu
- Department of Orthopedics, First Hospital of China Medical University, Shenyang, China
| | - Renyi Zhou
- Department of Orthopedics, First Hospital of China Medical University, Shenyang, China
- *Correspondence: Renyi Zhou,
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20
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Zhao J, Cai Q, Jiang D, Wang L, He H, Chen S, Jia W, Zhang C. The Impact of COVID-19 on SARSCoV-2-Negative Elderly Patients with Hip Fractures: A Single-Center Retrospective Study from Shanghai, China. Clin Interv Aging 2022; 17:991-999. [PMID: 35799949 PMCID: PMC9255716 DOI: 10.2147/cia.s374083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/22/2022] [Indexed: 01/08/2023] Open
Abstract
Purpose Coronavirus disease 2019 (COVID-19) has brought an unprecedented change in wellbeing globally. The spread of the pandemic reportedly reduced the incidence of activity-related trauma, while that of fragility fractures remained stable. Here, we aimed to identify the risk factors associated with the prognosis of SARS-CoV-2 negative elderly patients with hip fractures. Patients and Methods This retrospective study included elderly patients with hip fractures between 1st January and 9th May during the COVID-19 pandemic (Experiment group) and the same period from 2017 to 2019 (Control group). Perioperative mortality, complications, and functional recovery were compared between two groups of different time frame in the total cohort and patients who received surgical treatment. Multiple linear regression was carried out to identify the risk factors influencing the prognosis of COVID-negative elderly patients with hip fractures. Results The proportion of patients with admission time less than 24 hours and the 6-month postoperative Parker score were significantly decreased during COVID-19 compared with the pre-COVID-19 period (p < 0.001). Multiple linear regression demonstrated that TTA (defined as time from injury to admission), rehabilitation after discharge and outpatient follow-up were associated with the 6-month Parker score in the total population (p < 0.001) and in patients who received surgical treatment (p < 0.001). Conclusion Elderly patients with hip fractures had a poorer prognosis in epidemic period despite being COVID-19 negative. Factors including timely admission, postoperative follow-up, and rehabilitation could optimize safety and significantly improve the prognosis of elderly COVID-19 negative patients with hip fractures, even during a pandemic.
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Affiliation(s)
- Jinhui Zhao
- Department of Orthopedic Surgery, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai, 200233, People’s Republic of China
- Shanghai Institute of Microsurgery on Extremities, and Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233, People’s Republic of China
| | - Qianying Cai
- Shanghai Institute of Microsurgery on Extremities, and Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233, People’s Republic of China
| | - Dajun Jiang
- Department of Orthopedic Surgery, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai, 200233, People’s Republic of China
- Shanghai Institute of Microsurgery on Extremities, and Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233, People’s Republic of China
| | - Lingtian Wang
- Department of Orthopedic Surgery, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai, 200233, People’s Republic of China
- Shanghai Institute of Microsurgery on Extremities, and Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233, People’s Republic of China
| | - Haiyan He
- Shanghai Institute of Microsurgery on Extremities, and Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233, People’s Republic of China
| | - Shengbao Chen
- Shanghai Institute of Microsurgery on Extremities, and Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233, People’s Republic of China
| | - Weitao Jia
- Department of Orthopedic Surgery, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai, 200233, People’s Republic of China
- Shanghai Institute of Microsurgery on Extremities, and Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233, People’s Republic of China
- Correspondence: Weitao Jia; Changqing Zhang, Department of Orthopedic Surgery, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai, 200233, People’s Republic of China, Tel +86-18930173388; +86-21-64701361, Email ;
| | - Changqing Zhang
- Department of Orthopedic Surgery, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai, 200233, People’s Republic of China
- Shanghai Institute of Microsurgery on Extremities, and Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233, People’s Republic of China
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21
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Lau VI, Dhanoa S, Cheema H, Lewis K, Geeraert P, Lu D, Merrick B, Vander Leek A, Sebastianski M, Kula B, Chaudhuri D, Agarwal A, Niven DJ, Fiest KM, Stelfox HT, Zuege DJ, Rewa OG, Bagshaw SM. Non-COVID outcomes associated with the coronavirus disease-2019 (COVID-19) pandemic effects study (COPES): A systematic review and meta-analysis. PLoS One 2022; 17:e0269871. [PMID: 35749400 PMCID: PMC9231780 DOI: 10.1371/journal.pone.0269871] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 05/29/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND As the Coronavirus Disease-2019 (COVID-19) pandemic continues, healthcare providers struggle to manage both COVID-19 and non-COVID patients while still providing high-quality care. We conducted a systematic review/meta-analysis to describe the effects of the COVID-19 pandemic on patients with non-COVID illness and on healthcare systems compared to non-pandemic epochs. METHODS We searched Ovid MEDLINE/EMBASE/Cochrane Database of Systematic Reviews/CENTRAL/CINAHL (inception to December 31, 2020). All study types with COVID-pandemic time period (after December 31, 2019) with comparative non-pandemic time periods (prior to December 31, 2019). Data regarding study characteristics/case-mix/interventions/comparators/ outcomes (primary: mortality; secondary: morbidity/hospitalizations/disruptions-to-care. Paired reviewers conducted screening and abstraction, with conflicts resolved by discussion. Effect sizes for specific therapies were pooled using random-effects models. Risk of bias was assessed by Newcastle-Ottawa Scale, with evidence rating using GRADE methodology. RESULTS Of 11,581 citations, 167 studies met eligibility. Our meta-analysis showed an increased mortality of 16% during the COVID pandemic for non-COVID illness compared with 11% mortality during the pre-pandemic period (RR 1.38, 95% CI: 1.28-1.50; absolute risk difference: 5% [95% CI: 4-6%], p<0.00001, very low certainty evidence). Twenty-eight studies (17%) reported significant changes in morbidity (where 93% reported increases), while 30 studies (18%) reported no significant change (very low certainty). Thirty-nine studies (23%) reported significant changes in hospitalizations (97% reporting decreases), while 111 studies (66%) reported no significant change (very low certainty). Sixty-two studies (37%) reported significant disruptions in standards-to-care (73% reporting increases), while 62 studies (37%) reported no significant change (very low certainty). CONCLUSIONS There was a significant increase in mortality during the COVID pandemic compared to pre-pandemic times for non-COVID illnesses. When significant changes were reported, there was increased morbidity, decreased hospitalizations and increased disruptions in standards-of-care. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020201256 (Sept 2, 2020).
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Affiliation(s)
- Vincent Issac Lau
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Sumeet Dhanoa
- Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Harleen Cheema
- Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Kimberley Lewis
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Division of Critical Care Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Patrick Geeraert
- Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - David Lu
- Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Benjamin Merrick
- Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Aaron Vander Leek
- Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Meghan Sebastianski
- Alberta Strategy for Patient-Orientated Research Knowledge Translation Platform, University of Alberta, Edmonton, Alberta, Canada
| | - Brittany Kula
- Division of Infectious Disease, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
| | - Dipayan Chaudhuri
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Division of Critical Care Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Arnav Agarwal
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, General Internal Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Daniel J Niven
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada
- Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
| | - Kirsten M Fiest
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada
- Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
| | - Henry T Stelfox
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada
- Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Danny J Zuege
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada
- Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
| | - Oleksa G Rewa
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
- Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Sean M Bagshaw
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, Alberta, Canada
- Critical Care Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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22
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Levy M, Lestrade V, Said C, Jouvet P, Kawaguchi A. Consequences of Social Distancing Measures During the COVID-19 Pandemic First Wave on the Epidemiology of Children Admitted to Pediatric Emergency Departments and Pediatric Intensive Care Units: A Systematic Review. Front Pediatr 2022; 10:874045. [PMID: 35722481 PMCID: PMC9204064 DOI: 10.3389/fped.2022.874045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/28/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To synthesize knowledge describing the impact of social distancing measures (SDM) during the first wave of the COVID-19 pandemic on acute illness in children by focusing on the admission to pediatric emergency departments (PED) and pediatric intensive care units (PICU). Methods We searched Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, EPOC Register, MEDLINE, Evidence-Based Medicine Reviews, EMBASE, WHO database on COVID-19, Cochrane Resources on COVID-19, Oxford COVID-19 Evidence Service, Google Scholar for literature on COVID-19 including pre-print engines such as medRxiv, bioRxiv, Litcovid and SSRN for unpublished studies on COVID-19 in December 2020. We did not apply study design filtering. The primary outcomes of interest were the global incidence of admission to PICU and PED, disease etiologies, and elective/emergency surgeries, compared to the historical cohort in each studied region, country, or hospital. Results We identified 6,660 records and eighty-seven articles met our inclusion criteria. All the studies were with before and after study design compared with the historical data, with an overall high risk of bias. The median daily PED admissions decreased to 65% in 39 included studies and a 54% reduction in PICU admission in eight studies. A significant decline was reported in acute respiratory illness and LRTI in five studies with a median decrease of 63%. We did not find a consistent trend in the incidence of poisoning, but there was an increasing trend in burns, DKA, and a downward trend in trauma and unplanned surgeries. Conclusions SDMs in the first wave of the COVID-19 pandemic reduced the global incidence of pediatric acute illnesses. However, some disease groups, such as burns and DKA, showed a tendency to increase and its severity of illness at hospital presentation. Continual effort and research into the subject should be essential for us to better understand the effects of this new phenomenon of SDMs to protect the well-being of children. Systematic Review Registration Clinicaltrials.gov, identifier: CRD42020221215.
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Affiliation(s)
- Michael Levy
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Pediatric Critical Care, University of Montreal, Montréal, QC, Canada
- Pediatric Intensive Care Unit, Centre Hospitalier Universitaire Robert-Debré, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris, France
| | - Victor Lestrade
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Pediatric Critical Care, University of Montreal, Montréal, QC, Canada
| | - Carla Said
- School of Medicine, University of Paris Saclay, Paris, France
| | - Philippe Jouvet
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Pediatric Critical Care, University of Montreal, Montréal, QC, Canada
| | - Atsushi Kawaguchi
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Pediatric Critical Care, University of Montreal, Montréal, QC, Canada
- Department of Intensive Care Medicine, Pediatric Critical Care Medicine, Tokyo Women's Medical University, Tokyo, Japan
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23
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Bobovec D, Žigman T, Rajačić D, Ehrenfreund T, Prtorić A, Dobrić I. Impact of the earthquake during COVID-19 lockdown on fracture admission at a tertiary trauma centre in Croatia. Chin J Traumatol 2022; 25:166-169. [PMID: 35094910 PMCID: PMC8744397 DOI: 10.1016/j.cjtee.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/25/2021] [Accepted: 12/24/2021] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To determine the impact of an earthquake during COVID-19 lockdown on fracture admission at a tertiary trauma centre in Croatia. METHODS A case-control study was performed at the tertiary trauma centre registry. Two different periods were studied. The case group included a period during COVID-19 lockdown right after the earthquakes until the end of the confinement period in Croatia. And the control group corresponded to the equivalent period in 2019. We identified all consecutive patients who were admitted due to urgent care requirements for the musculoskeletal trauma. Patient's demographic data and admitting diagnoses were assessed. Data were analyzed by statistical procedures using the program MedCalc statistical software version 16.4.3. RESULTS We identified 178 emergency admissions due to musculoskeletal trauma. During the COVID-19 lockdown and post-earthquake period, there was a drastic reduction in total admissions (359 vs. 662; p < 0.0001) with an increased proportion of trauma admissions within the emergency admissions (34.9% vs. 26.5%; p = 0.02926, Z = -2.1825). Furthermore, in the case group there was a significant increase in hospital admissions due to ankle/foot trauma (11 vs. 2, p = 0.0126) and a trend towards a decrease in the admissions due to tibia fractures (5 vs. 12, p = 0.0896), however without statistical significance. Also, an increased proportion of women within the group of femoral fractures in both case group (81.6% vs. 52.6%, p = 0.00194, Z = 3.1033) and the control group (82.3% vs. 60.5%, p = 0.0232, Z = 2.2742) was observed. In both analyzed periods, the osteoporotic hip fracture was the most common independent admitting diagnosis. CONCLUSION It is crucial to understand how natural disasters like earthquakes influence the pattern of trauma admissions during a coexisting pandemic. Accordingly, healthcare systems have to be prepared for an increased influx of certain pathology, like foot and ankle trauma.
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Affiliation(s)
- Dino Bobovec
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia,Corresponding author.
| | - Tomislav Žigman
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Daniel Rajačić
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Tin Ehrenfreund
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Andreja Prtorić
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ivan Dobrić
- Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia,School of Medicine, University of Zagreb, Zagreb, Croatia
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24
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Lotan R, Prosso I, Klatzkin L, Hershkovich O. The Covid 19 Pandemic Effect on the Epidemiology of Thoracolumbar Fractures Presenting to the Emergency Department in Patients Above 65 years Old. Geriatr Orthop Surg Rehabil 2022; 13:21514593221098828. [PMID: 35479652 PMCID: PMC9036375 DOI: 10.1177/21514593221098828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 03/22/2022] [Accepted: 04/18/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Studies investigating the Covid-19 Pandemic’s orthopedic aspects are accumulating, including reports on a 10-33% decrease in hip fracture incidence alongside shorter times to surgery. Osteoporotic vertebral compression fractures (VCF) have not yet been discussed. This study evaluated the effect of the Covid-19 pandemic’s first wave on VCF in the elderly. Method A retrospective cohort of elderly patients diagnosed with VCF between 2018-19 (Pre-Covid-19 pandemic) to 2020. Results The cohort included 172 patients above 65 years with VCF during 2018-2020. Patients’ age and gender were similar between the two study groups. We found a higher proportion of high-energy VCF during 2020 (10.5% vs 6.7%). Incidence of recurrent fractures was 7.5 times higher during 2020 (5.3% vs .7%, P =.06), and significantly higher rates of Ankylosing Spondylitis or Diffuse Idiopathic Skeletal Hyperostosis in 2020 (7.9% vs 1.5%, P=.04). VCF ED admission rates were similar, with 60% treated conservatively. Admitted patients underwent more surgeries in 2020 (66.7% vs 60%, P =.71) and a tendency towards Precoutaneus Balloon Kyphoplasty (BKP) + fixation compared with BKP alone (15.8% in 2020 vs 7.5% in 2018-19, P =.29). RR for BKP + fixation vs BKP alone was 1.95, suggesting higher odds for a more complex surgery during the Covid-19 pandemic. The complication rate was significantly higher during 2020 (18.4% vs 3.7%, P <.001). Admission length was slightly longer during 2020 (12.2 days vs 9.9 days, P = .27), and time to surgery was marginally longer, 6.25 vs 5.3 days (P = .55). Many patients chose home over institutional rehabilitation during the Covid-19 pandemic (72.2% vs 58.8%). Conclusion The Covid-19 pandemic did not alter VCF incidence, but patients’ characteristics changed, affecting admissions, institutional rehabilitation, and a tendency towards complex surgery rather than BKP alone. It is still unclear if Covid-19 will remain an issue in the upcoming years, but its impact and lessons are still worthwhile.
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Affiliation(s)
- Raphael Lotan
- Department of Orthopedic Surgery, Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ilia Prosso
- Department of Orthopedic Surgery, Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lev Klatzkin
- Department of Orthopedic Surgery, Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Oded Hershkovich
- Department of Orthopedic Surgery, Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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25
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Mak IL, Wan EYF, Wong TKT, Lee WWJ, Chan EWY, Choi EPH, Chui CSL, Ip MSM, Lau WCS, Lau KK, Lee SF, Wong ICK, Yu EYT, Lam CLK. The Spill-Over Impact of the Novel Coronavirus-19 Pandemic on Medical Care and Disease Outcomes in Non-communicable Diseases: A Narrative Review. Public Health Rev 2022; 43:1604121. [PMID: 35574567 PMCID: PMC9091177 DOI: 10.3389/phrs.2022.1604121] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 03/07/2022] [Indexed: 12/15/2022] Open
Abstract
Objectives: The coronavirus-19 (COVID-19) pandemic has claimed more than 5 million lives worldwide by November 2021. Implementation of lockdown measures, reallocation of medical resources, compounded by the reluctance to seek help, makes it exceptionally challenging for people with non-communicable diseases (NCD) to manage their diseases. This review evaluates the spill-over impact of the COVID-19 pandemic on people with NCDs including cardiovascular diseases, cancer, diabetes mellitus, chronic respiratory disease, chronic kidney disease, dementia, mental health disorders, and musculoskeletal disorders. Methods: Literature published in English was identified from PubMed and medRxiv from January 1, 2019 to November 30, 2020. A total of 119 articles were selected from 6,546 publications found. Results: The reduction of in-person care, screening procedures, delays in diagnosis, treatment, and social distancing policies have unanimously led to undesirable impacts on both physical and psychological health of NCD patients. This is projected to contribute to more excess deaths in the future. Conclusion: The spill-over impact of COVID-19 on patients with NCD is just beginning to unravel, extra efforts must be taken for planning the resumption of NCD healthcare services post-pandemic.
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Affiliation(s)
- Ivy Lynn Mak
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong, Hong Kong SAR, China
| | - Teenie Kwan Tung Wong
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wendy Woo Jung Lee
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Esther Wai Yin Chan
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong, Hong Kong SAR, China
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Celine Sze Ling Chui
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong, Hong Kong SAR, China
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Mary Sau Man Ip
- Division of Respiratory Medicine, Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wallace Chak Sing Lau
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kui Kai Lau
- Division of Neurology, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Shing Fung Lee
- Department of Clinical Oncology, Queen Mary Hospital, Hospital Authority, Hong Kong, Hong Kong SAR, China
- Department of Clinical Oncology, Tuen Mun Hospital, Hospital Authority, Hong Kong, Hong Kong SAR, China
- Department of Radiation Oncology, National University Cancer Institute, Singapore, Singapore
| | - Ian Chi Kei Wong
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong, Hong Kong SAR, China
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom
| | - Esther Yee Tak Yu
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Cindy Lo Kuen Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Lv H, Zhang X, Wang J, Hou Z, Wang H, Li C, Wang W, Chen W, Zhang Y. Short-term effects of COVID-19 on the risk of traumatic fractures in China cities. Sci Rep 2022; 12:6528. [PMID: 35444225 PMCID: PMC9020760 DOI: 10.1038/s41598-022-10531-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/08/2022] [Indexed: 12/21/2022] Open
Abstract
This study aimed to investigate the association between COVID-19 and fracture risk and provide a targeted reference for the world through China’s experience. A nationally representative sample of COVID-19 prevalence areas selected using stratified random sampling was retrospectively analyzed. Age, sex, fracture site, mechanism of injury, and concurrent fractures of traumatic fracture patients in selected hospitals were collected from 10 January to 10 July 2020. The epidemiologic characteristics of traumatic fractures and the association between COVID-19 and fracture risk were explored using descriptive epidemiological methods and a distributed lag nonlinear model. A total of 67,249 patients (52.3% males, 49.4 ± 19.4 years old) with 68,989 fractures were included. The highest proportion of fractures were in the tibia and fibula (14.9%), followed by the femur (13.6%) and ulna and radius (12.5%). Low-energy fractures accounted for 23.3%. With the increase in newly confirmed COVID-19 cases, fracture risk decreased for children, young and middle-aged adults, elderly men, high-energy fractures, and residents in regions with < 1000 cumulative confirmed COVID-19 cases. Fracture risk decreased sharply in all residents except elderly women, for low-energy fractures, and in regions with > 1000 cumulative confirmed COVID-19 cases when newly confirmed COVID-19 cases increased in China. Primary (home) prevention measures are emphasized to prevent traumatic fractures.
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Affiliation(s)
- Hongzhi Lv
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, China
| | - Xiaolin Zhang
- Department of Epidemiology and Statistics, Hebei Medical University, Shijiazhuang, 050017, China
| | - Juan Wang
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, China
| | - Zhiyong Hou
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, China
| | - Haicheng Wang
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, China
| | - Chao Li
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, China
| | - Wenjuan Wang
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, China
| | - Wei Chen
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, China. .,NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, China.
| | - Yingze Zhang
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, China. .,NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, China.
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The effect of COVID-19 on adult traumatic orthopedic injuries: a database study. Eur J Trauma Emerg Surg 2022; 48:2813-2822. [PMID: 35318484 PMCID: PMC8940592 DOI: 10.1007/s00068-022-01947-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/09/2022] [Indexed: 11/17/2022]
Abstract
Purpose This study compares orthopedic injuries, procedures, and hospital outcomes of patients presenting to trauma centers in Pennsylvania before and during the COVID-19 pandemic. Methods A retrospective review of adult patients presenting to hospitals with Pennsylvania Trauma Systems Foundation (PTSF) designations was performed. All patients 18 years of age and older who presented with orthopedic injuries were included. Demographic information, injury and hospital stay details, and mortality were reviewed. Data were compared between the cohorts of patients presenting during April 2020 (COVID cohort) and April 2017, April 2018, and April 2019 (pre-COVID cohort). Results Overall, 14,858 patients were reviewed, and 9427 patients were included in this study. There were fewer orthopedic injuries (4868 vs. 6603 yearly mean) in the COVID cohort which led to fewer procedures (1763 vs. 2329 yearly mean). The COVID cohort had a significantly shorter mean hospital length of stay compared to the pre-COVID cohort (4.7 days versus 5.2 days, p = 0.01). A higher mortality rate was seen in the COVID cohort (n = 115, 6.1%) compared to the pre-COVID cohort (n = 305, 4.0%; p < 0.01). Conclusion The characteristics of orthopedic injuries sustained by patients presenting to trauma centers during the COVID pandemic were not different from prior to the pandemic. However, there were decreases in the number of orthopedic injuries and procedures accompanied by a 50% increase in mortality seen in these patients during the pandemic. Resources should be appropriately marshalled to prevent rises in-hospital mortality for patients with orthopedic trauma treated during a pandemic. Level of evidence Level III.
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da Silva AC, da Silva Santos G, Maluf EMCP, Borba VZC. Incidence of hip fractures during the COVID-19 pandemic in the Brazilian public health care system. Arch Osteoporos 2022; 17:42. [PMID: 35253090 PMCID: PMC8898593 DOI: 10.1007/s11657-022-01078-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 02/12/2022] [Indexed: 02/03/2023]
Abstract
This study compared the incidence of hip fractures before and during the COVID-19 pandemic in Brazil, aged ≥ 60 years excluding all fractures related to any trauma. There was a significant reduction in the number of hip fractures and the length of hospital stay during the period of social isolation. PURPOSE To compare the incidence of hip fractures before and during the COVID-19 pandemic in Brazil and in the main regions of the country in patients covered by the Brazilian public health care system (SUS). As far as we are aware, no studies have evaluated the impact of COVID-19 pandemic on hip fractures in Brazil. METHODS Descriptive, cross-sectional study in individuals aged ≥ 60 years who presented with a hip fracture before and during the COVID-19 pandemic and received treatment covered by the SUS. The data were collected from the DATASUS electronic database. We calculated the incidence, mortality, lethality, duration of hospitalization, and average reimbursement associated with the treatment of the fractures. RESULTS There was a significant reduction in the incidence of hip fractures among individuals aged ≥ 60 years in Brazil during the period of social isolation due to COVID-19. The observed incidence was 15.58/10,000 inhabitants between March and December 2020 and 16.07/10,000 inhabitants in the same period of 2019 (p < 0.005; main decline observed in the age groups > 70 years). The average length of hospital stay reduced from 8.35 days in 2019 to 7.33 days in 2020, following a similar pattern of reduction across all regions. The Southeast was the only region with a significant reduction in mortality during the pandemic (relative risk 0.90, 95% confidence interval 0.84-0.97, p < 0.005). CONCLUSION During the COVID-19 pandemic in Brazil, the incidence rate of hip fractures and the associated duration of hospital stay decreased among patients aged ≥ 60 years.
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Affiliation(s)
| | | | | | - Victoria Zeghbi Cochenksi Borba
- Department of Internal Medicine, Endocrine Division (SEMPR), Federal University of Paraná, Av. Agostinho Leão Júnior, 285–80030-110, Curitiba (Paraná), Brazil
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Lv H, Chen W, Yao M, Hou Z, Zhang Y. Collecting data on fractures: a review of epidemiological studies on orthopaedic traumatology and the Chinese experience in large volume databases. INTERNATIONAL ORTHOPAEDICS 2022; 46:945-951. [DOI: 10.1007/s00264-022-05299-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/29/2021] [Indexed: 10/19/2022]
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Yao M, Wang H, Chen W. Clinical research-When it matters. Injury 2022:S0020-1383(22)00079-1. [PMID: 35144806 DOI: 10.1016/j.injury.2022.01.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/29/2022] [Indexed: 02/02/2023]
Abstract
Clinical research runs through the entire progress of the science and technology which has been currently and previously applied to the medical field. It has gradually developed into a standardized procedure and played an important role in understanding the etiology and characteristics of diseases. Clinical researchs assess the effectiveness and safety of new/improved diagnostic or therapeutic technologies, implants, instruments, or drug applications, to discover new data and improve potential deficiencies in previous medical knowledge.
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Affiliation(s)
- Mengxuan Yao
- Trauma Emergency Center, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China; Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang 050051, Hebei, China; Orthopaedic Institution of Hebei Province, Shijiazhuang, Hebei 050051, China
| | - Haicheng Wang
- Trauma Emergency Center, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China; Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang 050051, Hebei, China; Orthopaedic Institution of Hebei Province, Shijiazhuang, Hebei 050051, China
| | - Wei Chen
- Trauma Emergency Center, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China; NHC Key Laboratory of Intelligent Orthopeadic Equipment, Shijiazhuang, Hebei 050051, China.
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Hodhody G, Lum JW, Afzal S, Mulgrew EV. The COVID CLAVICLE Study: A predictor of future trauma trends. JSES Int 2022; 6:362-367. [PMID: 35128502 PMCID: PMC8805908 DOI: 10.1016/j.jseint.2021.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Clavicle fractures are a common presentation to the emergency department after falls and sporting injuries. During 2020, the coronavirus disease 2019 (COVID-19) pandemic brought with it a long period of social isolation, resulting in a change of behavior patterns and, in return, the presentation of fractures to our local hospitals. The effects of this global pandemic on the presentation and management of clavicles were noted with particular interest to the change in mechanism and its future implications. Methods We performed a longitudinal observational study in 10 hospitals in the North West of England, reviewing all patients presenting with a clavicle fracture during 6 weeks in the first peak of COVID-19 pandemic and compared these with the same period in 2019. Collection points included the patient demographics, fracture characteristics, mechanism of injury, and management. Results A total of 427 clavicle fractures were assessed with lower numbers of patients presenting with a clavicle fracture during the COVID-2020 period (n = 177) compared with 2019 (n = 250). Cycling-related clavicle fractures increased 3-fold during the pandemic compared with the 2019 control group. We also noted an overall increase in clavicle fractures resulting from higher energy trauma as opposed to low energy or fragility fracture. We also found a faster time to surgery in the COVID cohort by 2.7 days on average when compared with 2019. Conclusions Government restrictions and the encouragement of social distancing led to behavioral changes with a vast increase in cyclists on the road. This created a significant rise in clavicle fractures related to this activity. This is likely to be further driven by the government pledge to double cyclists on the road by 2025 in the United Kingdom. We forecast that this increase in cyclists, a behavior change accelerated by the pandemic, is a reliable predictor for future trauma trends.
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Tonk CH, Shoushrah SH, Babczyk P, El Khaldi-Hansen B, Schulze M, Herten M, Tobiasch E. Therapeutic Treatments for Osteoporosis-Which Combination of Pills Is the Best among the Bad? Int J Mol Sci 2022; 23:1393. [PMID: 35163315 PMCID: PMC8836178 DOI: 10.3390/ijms23031393] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 12/13/2022] Open
Abstract
Osteoporosis is a chronical, systemic skeletal disorder characterized by an increase in bone resorption, which leads to reduced bone density. The reduction in bone mineral density and therefore low bone mass results in an increased risk of fractures. Osteoporosis is caused by an imbalance in the normally strictly regulated bone homeostasis. This imbalance is caused by overactive bone-resorbing osteoclasts, while bone-synthesizing osteoblasts do not compensate for this. In this review, the mechanism is presented, underlined by in vitro and animal models to investigate this imbalance as well as the current status of clinical trials. Furthermore, new therapeutic strategies for osteoporosis are presented, such as anabolic treatments and catabolic treatments and treatments using biomaterials and biomolecules. Another focus is on new combination therapies with multiple drugs which are currently considered more beneficial for the treatment of osteoporosis than monotherapies. Taken together, this review starts with an overview and ends with the newest approaches for osteoporosis therapies and a future perspective not presented so far.
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Affiliation(s)
- Christian Horst Tonk
- Department of Natural Sciences, Bonn-Rhein-Sieg University of Applied Sciences, von-Liebig-Str. 20, 53359 Rheinbach, Germany; (C.H.T.); (S.H.S.); (P.B.); (B.E.K.-H.); (M.S.); (E.T.)
| | - Sarah Hani Shoushrah
- Department of Natural Sciences, Bonn-Rhein-Sieg University of Applied Sciences, von-Liebig-Str. 20, 53359 Rheinbach, Germany; (C.H.T.); (S.H.S.); (P.B.); (B.E.K.-H.); (M.S.); (E.T.)
| | - Patrick Babczyk
- Department of Natural Sciences, Bonn-Rhein-Sieg University of Applied Sciences, von-Liebig-Str. 20, 53359 Rheinbach, Germany; (C.H.T.); (S.H.S.); (P.B.); (B.E.K.-H.); (M.S.); (E.T.)
| | - Basma El Khaldi-Hansen
- Department of Natural Sciences, Bonn-Rhein-Sieg University of Applied Sciences, von-Liebig-Str. 20, 53359 Rheinbach, Germany; (C.H.T.); (S.H.S.); (P.B.); (B.E.K.-H.); (M.S.); (E.T.)
| | - Margit Schulze
- Department of Natural Sciences, Bonn-Rhein-Sieg University of Applied Sciences, von-Liebig-Str. 20, 53359 Rheinbach, Germany; (C.H.T.); (S.H.S.); (P.B.); (B.E.K.-H.); (M.S.); (E.T.)
| | - Monika Herten
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Edda Tobiasch
- Department of Natural Sciences, Bonn-Rhein-Sieg University of Applied Sciences, von-Liebig-Str. 20, 53359 Rheinbach, Germany; (C.H.T.); (S.H.S.); (P.B.); (B.E.K.-H.); (M.S.); (E.T.)
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Özşahin MK, Değer GU, Aydın N. The impact of COVID-19 pandemic in the first 100 days on orthopedic trauma surgery practice, the experience of a university hospital in Istanbul. ULUS TRAVMA ACIL CER 2022; 28:27-32. [PMID: 34967425 PMCID: PMC10443172 DOI: 10.14744/tjtes.2021.23796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 02/14/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND With the rapid and effective change created by the COVID-19 pandemic in all medical practice, we aimed to evaluate the impact of the first 100 days of the COVID-19 pandemic on the operations performed in a reference university hospital in the field of orthopedics and traumatology. Compare the results with the same period of the previous year and aim to evaluate importance of restrictions. METHODS The operations performed in orthopedics and traumatology clinic between March 18, 2020 (the day we stopped the elective surgeries), and July 1, 2020 (when the normalization process began), were collected from the electronic archive to compare with the same period of 2019. RESULTS Comparing the same periods of the year, it was seen that 102 surgeries were performed in the 2020 COVID-19 period compared to 380 operations performed in 2019. Although most of the operations performed during the COVID-19 period were traumas, the comparison revealed that trauma cases decreased by 25% from 73 to 58 (p<0.001). Among trauma patients operated in the restraint period, decrease in the pediatric group and the increase in patients over 65 years of age had seen statistically significant. Compared to the same period of the previous year, 50% increase seen in amputation cases related to diabetic foot (p<0.001). CONCLUSION The postponement of elective cases due to the COVID-19 pandemic enabled us to manage trauma cases despite decreasing capacity utilization. In addition, it was observed that the transition of schools to online education and the implementation of curfews significantly reduced the number of trauma in the pediatric group. Separation of operating rooms and wards had a huge effect on protection of non-COVID patients. We hope that, in light of this study, we can guide health policies and help other colleagues to manage the possible new waves of the pandemic process or similar processes that may occur in the future.
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Affiliation(s)
- Mahmut Kürşat Özşahin
- Department of Orthopaedics and Traumatology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul-Turkey
| | - Göker Utku Değer
- Department of Orthopaedics and Traumatology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul-Turkey
| | - Nuri Aydın
- Department of Orthopaedics and Traumatology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul-Turkey
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SILVA ANGELADRIANYDA, STRÖHER GABRIELAREDIVO, TEIXEIRA HELOÍSAMORO, CORDEIRO MARIAVICTÓRIAGUTIERREZ, OLANDOSKI MARCIA, VON-BAHTEN LUIZCARLOS. Impacto da pandemia da COVID-19 na epidemiologia dos acidentes de trânsito: um estudo transversal. Rev Col Bras Cir 2022. [DOI: 10.1590/0100-6991e-20223364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
RESUMO Introdução: avaliar o perfil epidemiológico das vítimas de acidentes de trânsito no contexto da pandemia da doença do coronavírus 2019 (COVID-19), analisar os atendimentos entre os níveis de restrição implementados (bandeiras) e comparar os dados com o período pré-pandêmico. Métodos: trata-se de um estudo transversal, com amostragem probabilística, realizado em um hospital de trauma no sul do Brasil utilizando prontuários de pacientes vítimas de acidente de trânsito entre junho de 2020 a maio de 2021. Além das variáveis epidemiológicas, coletou-se a bandeira vigente, o mecanismo de trauma, as lesões resultantes e o Revised Trauma Score (RTS). Os dados foram comparados entre as três bandeiras e a proporção de atendimentos do período pandêmico foi comparada com a do período pré-pandêmico (dezembro de 2016 a fevereiro de 2018). Resultados: observou-se que 62,2% dos pacientes foram vítimas de acidentes com motocicletas, 77,5% da amostra era do sexo masculino e que a média etária foi de 33 ± 12,4 anos. A média e mediana do RTS foram 7,5 e 7,8, respectivamente. Houve diferença significativa ao comparar o número de atendimentos ao dia entre as bandeiras amarela e vermelha (p=0,001) e laranja e vermelha (p=0,016). Constatou-se um número significativamente menor de atendimentos por acidentes de trânsito no período pandêmico quando comparado com o período pré-pandêmico. Conclusões: o perfil epidemiológico do estudo foi composto em sua maioria por homens jovens vítimas de acidentes com motocicleta. Houve menor incidência de admissões na bandeira vermelha e menor proporção de atendimentos no período da pesquisa quando comparado ao pré-pandêmico.
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Affiliation(s)
| | | | | | | | | | - LUIZ CARLOS VON-BAHTEN
- Hospital Universitário Cajuru, Brasil; Universidade Federal do Paraná, Brazil; Pontifícia Universidade Católica do Paraná, Brazil
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Jungmann F, Kämpgen B, Hahn F, Wagner D, Mildenberger P, Düber C, Kloeckner R. Natural language processing of radiology reports to investigate the effects of the COVID-19 pandemic on the incidence and age distribution of fractures. Skeletal Radiol 2022; 51:375-380. [PMID: 33851252 PMCID: PMC8043440 DOI: 10.1007/s00256-021-03760-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE During the COVID-19 pandemic, the number of patients presenting in hospitals because of emergency conditions decreased. Radiology is thus confronted with the effects of the pandemic. The aim of this study was to use natural language processing (NLP) to automatically analyze the number and distribution of fractures during the pandemic and in the 5 years before the pandemic. MATERIALS AND METHODS We used a pre-trained commercially available NLP engine to automatically categorize 5397 radiological reports of radiographs (hand/wrist, elbow, shoulder, ankle, knee, pelvis/hip) within a 6-week period from March to April in 2015-2020 into "fracture affirmed" or "fracture not affirmed." The NLP engine achieved an F1 score of 0.81 compared to human annotators. RESULTS In 2020, we found a significant decrease of fractures in general (p < 0.001); the average number of fractures in 2015-2019 was 295, whereas it was 233 in 2020. In children and adolescents (p < 0.001), and in adults up to 65 years (p = 0.006), significantly fewer fractures were reported in 2020. The number of fractures in the elderly did not change (p = 0.15). The number of hand/wrist fractures (p < 0.001) and fractures of the elbow (p < 0.001) was significantly lower in 2020 compared with the average in the years 2015-2019. CONCLUSION NLP can be used to identify relevant changes in the number of pathologies as shown here for the use case fracture detection. This may trigger root cause analysis and enable automated real-time monitoring in radiology.
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Affiliation(s)
- Florian Jungmann
- grid.410607.4Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckst. 1, 55131 Mainz, Germany
| | - B. Kämpgen
- grid.424427.3Empolis Information Management, Kaiserslautern, Germany
| | - F. Hahn
- grid.410607.4Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckst. 1, 55131 Mainz, Germany
| | - D. Wagner
- grid.410607.4Department of Orthopedics and Traumatology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - P. Mildenberger
- grid.410607.4Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckst. 1, 55131 Mainz, Germany
| | - C. Düber
- grid.410607.4Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckst. 1, 55131 Mainz, Germany
| | - R. Kloeckner
- grid.410607.4Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckst. 1, 55131 Mainz, Germany
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Juhani WSA, Alanazi AM, Aldusari RS. Epidemiological characteristics of traumatic musculoskeletal injuries during the COVID-19 pandemic at a single tertiary hospital. J Family Med Prim Care 2021; 10:3882-3887. [PMID: 34934696 PMCID: PMC8653492 DOI: 10.4103/jfmpc.jfmpc_2463_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/28/2021] [Accepted: 05/03/2021] [Indexed: 11/04/2022] Open
Abstract
Background Musculoskeletal (MSK) injuries are common but can lead to devastating outcomes. During the COVID-19 pandemic in Saudi Arabia, it is thought that the burden of traumatic MSK injuries is minimized. Objective This study aimed to assess the epidemiological characteristics of traumatic MSK injuries during the lockdown period in Saudi Arabia. Materials and Methods This retrospective descriptive study included all patients who were admitted to the orthopedic department at a single tertiary hospital level 1 trauma center due to traumatic injuries from March 23 to June 21, 2020. Results The study included 92 patients. The majority were male (68.5%). The most common comorbidity was hypertension (30.4%). Falls were the most common mechanism of injury (47%). The most common sites to be fractured were the proximal femur (22.8%) followed by the distal tibia/fibula (14%). Skull fractures (12%), rib fractures (6.5%), and pneumothorax (6.5%) were the most common associated injuries. Age and the number of injuries were significant predictors of increased length of hospital stay. Conclusions Major considerations for primary prevention must be taken into account during long periods of time with no direct patient interaction. Patient education is important to help avoid any burden that might be caused by otherwise preventable injuries. Further studies should be conducted to assess this phenomenon more in depth and to establish the appropriate method of educating patients on primary prevention.
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Affiliation(s)
- Wazzan S Al Juhani
- Department of Surgery, Ministry of National Guard Health Affairs, King Abdullah International Medical Research Center, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdullah M Alanazi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Rakan S Aldusari
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Cromer SJ, Yu EW. Challenges and Opportunities for Osteoporosis Care During the COVID-19 Pandemic. J Clin Endocrinol Metab 2021; 106:e4795-e4808. [PMID: 34343287 PMCID: PMC8385842 DOI: 10.1210/clinem/dgab570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE The coronavirus disease 2019 (COVID-19) has both directly and indirectly affected osteoporosis diagnosis and treatment throughout the world. METHODS This mini-review summarizes the available evidence regarding the effects of COVID-19, its treatment, and the consequences of the pandemic itself on bone health. Additionally, we review evidence and expert recommendations regarding putative effects of osteoporosis medications on COVID-19 outcomes and vaccine efficacy and summarize recommendations for continuation of osteoporosis treatment during the pandemic. RESULTS The use of standard screening procedures to assess for osteoporosis and fracture risk declined dramatically early in the pandemic, while rates of fragility fractures were largely unchanged. COVID-19, its treatments, and public health measures to prevent viral spread are each likely to negatively affect bone health. Osteoporosis treatments are not known to increase risk of adverse events from COVID-19, and preclinical data suggest possible beneficial effects of some therapies. Vitamin D deficiency is clearly associated with adverse outcomes from COVID-19, but it remains unclear whether vitamin D supplementation may improve outcomes. Osteoporosis treatment should be continued whenever possible, and recommendations for substituting therapies, if required, are available. CONCLUSION The COVID-19 pandemic has decreased screening and disrupted treatment for osteoporosis. Osteoporosis medications are safe and effective during the pandemic and should be continued whenever possible. Further studies are needed to fully understand the impact of the COVID-19 pandemic on long-term bone health.
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Affiliation(s)
- Sara J Cromer
- Division of Endocrinology, Diabetes, and Metabolism; Massachusetts General Hospital; Boston, MA
- Harvard Medical School;Boston, MA
| | - Elaine W Yu
- Division of Endocrinology, Diabetes, and Metabolism; Massachusetts General Hospital; Boston, MA
- Harvard Medical School;Boston, MA
- Corresponding Author: Elaine W. Yu, MD, MGH Endocrine Unit, 50 Blossom Street, Thier 1051, Boston, MA 02114,
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Kazubski K, Tomczyk Ł, Morasiewicz P. Effects of the COVID-19 Pandemic on the Epidemiology of Knee and Shoulder Arthroscopy. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2021; 58:469580211056037. [PMID: 34775868 PMCID: PMC8645303 DOI: 10.1177/00469580211056037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of our study was to comprehensively assess the effect of the COVID-19 pandemic on knee and shoulder arthroscopy performed in an orthopedic department of a university hospital in Poland. This study compared the data on all shoulder and knee arthroscopy procedures performed in two different periods: The period of the COVID-19 pandemic in Poland (from March 4, 2020, to October 15, 2020) and the corresponding period prior to the pandemic (March 4, 2019, to October 15, 2019). The study evaluated epidemiological data, demographic data, and hospital stay duration. The total number of arthroscopy procedures conducted in the evaluated period in 2020 was approximately 8.6% higher than that in the corresponding 2019 period. The mean duration of hospital stay for orthopedic patients after their knee or shoulder arthroscopy was 3.1 days in 2020 and 2.8 days in 2019. Our study revealed the mean age of arthroscopy patients during the pandemic to be lower at 48.4 years than the 51.2 years recorded in 2019. The male-to-female ratio was shown to be lower at .85 during the pandemic, having decreased from 1.5 in 2019. The COVID-19 pandemic did not reduce the number of arthroscopy performed at our center, and the mean age of the patients did not change. However, the pandemic had a marked effect on the mean duration of hospital stay and male-to-female ratio.
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Affiliation(s)
- Krystian Kazubski
- Department of Orthopaedic and Trauma Surgery, University Hospital in Opole, Institute of Medical Sciences, 49576University of Opole, Opole, Poland
| | - Łukasz Tomczyk
- Department of Food Safety and Quality Management, 49645Poznan University of Life Sciences, Poznan, Poland
| | - Piotr Morasiewicz
- Department of Orthopaedic and Trauma Surgery, University Hospital in Opole, Institute of Medical Sciences, 49576University of Opole, Opole, Poland
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The effect of physical and social isolation due to the COVID-19 pandemic on the incidence of hip fractures among senior citizens. Geriatr Nurs 2021; 43:21-25. [PMID: 34798310 PMCID: PMC8531412 DOI: 10.1016/j.gerinurse.2021.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 12/04/2022]
Abstract
This study aimed to explore the effects of the lockdown due to the coronavirus disease 2019 pandemic on the incidence and characteristics of hip fracture in older adults. Data from the three-month lockdown period and the corresponding period in the previous year were obtained from the computerized medical records of a large acute-care hospital. No significant differences were observed in the absolute and relative numbers of hip fractures. There were no significant differences in terms of socio-demographic and clinical characteristics, which are considered risk factors for falls. Similarly, there was no difference in the length of time between admission and surgery and the mean length of hospital stay. Compared to the previous year, there was a significantly higher incidence of hip fractures in older adults living alone during the lockdown. Health policy should provide social support and monitoring of healthcare, particularly to older adults living alone.
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Mills S, Ibarzábal-Gil A, Martínez-Diez JM, Pallarés-Sanmartín J, Kalbakdij-Sánchez C, Rubio-Suárez JC, Losantos-García I, Rodríguez-Merchán EC. SARS-CoV-2 outbreak impact on a trauma unit. World J Orthop 2021; 12:751-759. [PMID: 34754831 PMCID: PMC8554347 DOI: 10.5312/wjo.v12.i10.751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/17/2021] [Accepted: 08/18/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND From February 2020 onwards, our country has been hit by the coronavirus severe acute respiratory syndrome-2 (SARS-CoV-2) infection. At a glance, hospitals became overrun and had to reformulate all the assistance guidelines, focusing on the coronavirus disease 2019. One year after the start of the pandemic, we present the results of a morbimortality study.
AIM To analyze how our department was affected by the outbreak in terms of morbimortality, and to analyze demographic data, admission to hospital-related data, and subgroups analyses for patients with hip fractures and polytrauma.
METHODS We designed a study comparing data from patients who were admitted to our unit due to a lower limb fracture or a high energy trauma during the pandemic (from March to April 2020) to those admitted during the same period in 2019 before the pandemic. during the pandemic situation. Both cohorts completed a minimum of 6 mo of follow-up.
RESULTS The number of patients admitted to hospital in 2020 was nearly half of those in 2019. Hip fractures in the elderly represented 52 out of 73 of the admitted patients. Twenty patients had a positive test result for SARS-CoV-2 infection. Patients with SARS-CoV-2 infection were admitted to the hospital for a longer time than the non-infected (P < 0.001), and had a higher mortality rate during hospitalization and follow-up (P = 0.02). Patients with a hip fracture associated with a severe respiratory syndrome were mostly selected for conservative treatment (P = 0.03).
CONCLUSION Mortality and readmission rates were higher in the 2020 cohort and during follow-up, in comparison with the cohort in 2019.
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Affiliation(s)
- Sarah Mills
- Department of Orthopedic Surgery, La Paz University Hospital, Madrid, Spain
| | | | | | | | | | | | | | - E Carlos Rodríguez-Merchán
- Department of Orthopedic Surgery, La Paz University Hospital, Madrid, Spain
- Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research – IdiPAZ (La Paz University Hospital – Autonomous University of Madrid), Madrid, Spain
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Toy S, Polat O, Özbay H. Coronavirus disease 2019 pandemic, restriction, and orthopedic trauma: Retrospective observational study. Medicine (Baltimore) 2021; 100:e27166. [PMID: 34477174 PMCID: PMC8415988 DOI: 10.1097/md.0000000000027166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/20/2021] [Indexed: 01/05/2023] Open
Abstract
In 2019, the Coronavirus disease 2019 (Covid-19) was reported in Wuhan, China. Governments in various countries had taken many safeguards. This study investigated the incidence of orthopedic trauma in a rural region epidemiologically and guided source distribution and medical professionals to sustain healthcare systems.Between December 2019 and August 2020, 1651 patients admitted to orthopedics and traumatology clinics with trauma were evaluated in this study. Patients were grouped into 3 groups: pre-covid, restriction, and permitted groups. Age, sex, and fracture types of patients were recorded.The number of patients in the pre-covid period was 629 (38.1%), those were 334 (20.2%) in the restriction period, and 688 (41.7%) patients were admitted in the permitted period. A total of 1203 (72.9%) patients with upper extremity fractures, 383 (23.2%) patients with lower extremity fractures, and 65 (3.9%) patients with axial skeleton and pelvic ring fractures were included in the study. The lowest rates were found in the restriction period when all fractures were evaluated according to the admission periods. There were significant differences between admission dates and the fractures (P < .001).In this study, a decrease in orthopedic trauma rates was observed by half in the restriction period compared with the other 2 periods. Public health precautions had led to a reduction in the incidence of orthopedic trauma in all age groups.
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Ojeda-Thies C, Cuarental-García J, Ramos-Pascua LR. Decreased volume of hip fractures observed during COVID-19 lockdown. Eur Geriatr Med 2021; 12:759-766. [PMID: 33481186 PMCID: PMC7820835 DOI: 10.1007/s41999-020-00447-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 12/28/2020] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The aim was to study the incidence and characteristics of fragility hip fractures admitted during COVID-19 lockdown. MATERIALS AND METHODS We analysed socio-demographic and baseline characteristics of patients suffering fragility hip fractures between March 1st and May 1st 2020, period most affected by COVID-19 confinement measures. Cases (n = 64) were compared with controls (n = 172) from corresponding periods in 2018 and 2019. Poisson Generalised Linear Model regression analysis was performed to compare daily case counts, and LOESS curves compared time series. RESULTS No differences were found regarding age or gender distributions, pre-fracture living, ambulatory, functional or cognitive status. More patients in 2020 had a high-risk ASA score. Fewer cases [Reduction = 26% (95% CI 1-44%)] were admitted in 2020. The reduction seemed to correspond with confinement. CONCLUSIONS Approximately, one quarter less fragility hip fractures were admitted to our hospital during lockdown. Patients' baseline status and socio-demographic characteristics were similar.
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Affiliation(s)
- Cristina Ojeda-Thies
- Department of Traumatology and Orthopaedic Surgery, Hospital Universitario 12 de Octubre, Avda Córdoba s/n, 28041, Madrid, Spain.
| | - Javier Cuarental-García
- Department of Traumatology and Orthopaedic Surgery, Hospital Universitario 12 de Octubre, Avda Córdoba s/n, 28041, Madrid, Spain
| | - Luis Rafael Ramos-Pascua
- Department of Traumatology and Orthopaedic Surgery, Hospital Universitario 12 de Octubre, Avda Córdoba s/n, 28041, Madrid, Spain
- Department of Surgery, School of Medicine, Complutense University of Madrid, Madrid, Spain
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Patralekh MK, Jain VK, Iyengar KP, Upadhyaya GK, Vaishya R. Mortality escalates in patients of proximal femoral fractures with COVID-19: A systematic review and meta-analysis of 35 studies on 4255 patients. J Clin Orthop Trauma 2021; 18:80-93. [PMID: 33897205 PMCID: PMC8056882 DOI: 10.1016/j.jcot.2021.03.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 03/26/2021] [Accepted: 03/30/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Concerns have been raised about the escalated mortality in patients of proximal femoral fractures (PPFs) with COVID-19. A meta-analysis to evaluate the mortality in patients with PPFs managed during the current COVID-19 pandemic was conducted. METHODS A systematic review and meta-analysis of all published studies were conducted with a search on PubMed, Scopus, Web of Science, and Cochrane Library databases using appropriate keywords from January 01, 2020 to January 29, 2021. RESULTS 35 relevant studies reporting 4255 patients with hip fracture in the current ongoing pandemic, out of which 692 patients were COVID-19 positive. Twenty studies reported mortality and other relevant statistics on hip fracture patients with and without COVID-19 (4123 hip fracture patients in the year 2020-21, out of which 560 had or were suspected of having COVID -19). A meta-analysis of mortality statistics in patients with and without COVID revealed increased odds of mortality among COVID patients [odds ratio (OR) 6.31, 95% confidence interval (CI) [5.09, 7.83] and meta-analysis on the subgroup of surgically treated patients also showed markedly increased mortality risk among those with COVID-19 (OR) 5.99, 95% CI [3.88,9.24]. CONCLUSION The mortality risk is markedly increased in hip fracture with concomitant COVID-19 as compared to those without it. This increased risk persisted in those managed surgically. It could be due to the inflammation induced by the fracture or surgery for fracture fixation, further exacerbating inflammation, leading to cytokine storm. It is imperative that such patients are informed regarding increased mortality risk during the consent and shared decision-making process.
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Affiliation(s)
- Mohit Kumar Patralekh
- Department of Orthopaedics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110 029, India
| | - Vijay Kumar Jain
- Department of Orthopaedics, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India
| | - Karthikeyan P. Iyengar
- Trauma and Orthopaedic Surgeon, Southport and Ormskirk NHS Trust, Southport, PR8 6PN, UK
| | - Gaurav Kumar Upadhyaya
- Department of Orthopaedics, All India Institute of Medical Sciences, Rae Bareli, UP, India
| | - Raju Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospital, Sarita Vihar, Mathura Road, 110076, New Delhi, India
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Oguzkaya S, Misir A, Ozcamdalli M, Eken G, Kizkapan TB, Kurk MB, Uzun E. Impact of the COVID-19 pandemic on orthopedic fracture characteristics in three hospitals in Turkey: A multi-center epidemiological study. Jt Dis Relat Surg 2021; 32:323-332. [PMID: 34145802 PMCID: PMC8343845 DOI: 10.52312/jdrs.2021.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/12/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives
In this study, we present the use of case specific three- dimensional (3D) printed plastic models and custom-made acetabular implants in orthopedic surgery. Materials and methods
Between March 2018 and September 2020, surgeries were simulated using plastic models manufactured by 3D printers on the two patients with pilon fractures. Also, custom-made acetabular implants were used on two patients with an acetabular bone defect for the revision of total hip arthroplasty (THA). Results
More comfortable surgeries were experienced in pilon fractures using preoperative plastic models. Similarly, during the follow-up period, the patients that applied custom-made acetabular implants showed a fixed and well-positioning in radiographic examination. These patients did not experience any surgical complications and achieved an excellent recovery. Conclusion
Preoperative surgical simulation with 3D printed models can increase the comfort of fracture surgeries. Also, custom-made 3D printed acetabular implants can perform an important task in patients treated with revision THA surgery due to severe acetabular defects.
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Affiliation(s)
- Sinan Oguzkaya
- Sarkışla Devlet Hastanesi Ortopedi ve Travmatoloji Kliniği, 58400 Sarkışla, Sivas, Türkiye.
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Oguzkaya S, Misir A, Ozcamdalli M, Eken G, Kizkapan TB, Kurk MB, Uzun E. Impact of the COVID-19 pandemic on orthopedic fracture characteristics in three hospitals in Turkey: A multi-center epidemiological study. Jt Dis Relat Surg 2021. [PMID: 34145807 PMCID: PMC8343834 DOI: 10.52312/jdrs.2021.2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objectives
The aim of this study was to evaluate the impact of novel coronavirus-2019 (COVID-19) on the epidemiological characteristics of orthopedic fractures. Patients and methods
A total of 2,960 patients (1,755 males, 1,205 females; mean age: 39.6 years; range, 1 to 98 years) with orthopedic fractures were included in the study: 552 patients during the pandemic period (March 10th and July 1st, 2020) and 1,158 control patients in the same period 2019 and 1,250 control patients in 2018. Epidemiological characteristics, injury mechanisms, fracture locations and treatment details of the patients were analyzed and compared between 2018, 2019 and 2020 for adult and pediatric populations. Results
Of a total of 552 patients, 485 were adults and 67 were pediatric patients. In the control groups, of 1,158 patients (2019), 770 were adults and 378 were pediatric patients and, of 1,250 patients (2018), 857 were adults and 393 were pediatric patients. The proportion of proximal femur and hand fractures significantly increased during the pandemic period (p=0.025 and p=0.038, respectively). The most frequent surgical indication in the pandemic period was proximal femoral fracture. The proportion of home accidents as an injury mechanism significantly increased in the pandemic period compared to 2018 and 2019 (48.5% vs. 18.6% and 20.6%, respectively; p=0.000). The proportion of female pediatric patients significantly increased during the pandemic period compared to 2018 and 2019 (44.8% vs. 25.4% and 27.2%, respectively, p=0.004). The proportion of forearm fractures (p=0.001) also increased, and the proportion of tibia-fibula fractures (p=0.03) decreased. The most frequent surgical indication in pediatric patients was distal humeral fracture in both groups. Conclusion
During the pandemic period, proximal femoral fractures in the elderly remained a concern. In-home preventative strategies may be beneficial to reduce the incidence of hip fractures in the elderly.
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Affiliation(s)
- Sinan Oguzkaya
- Sarkışla Devlet Hastanesi Ortopedi ve Travmatoloji Kliniği, 58400 Sarkışla, Sivas, Türkiye.
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AKTI S, ÇANKAYA D. The Effect of the COVID-19 Pandemic on the Epidemiology of Hip Fractures. ACTA MEDICA ALANYA 2021. [DOI: 10.30565/medalanya.866332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Tsourdi E, Yu EW, Jan de Beur SM, Drake MT. Vaccination for Coronavirus Disease 2019 (COVID-19) and Relationship to Osteoporosis Care: Current Evidence and Suggested Approaches. J Bone Miner Res 2021; 36:1042-1047. [PMID: 33831269 PMCID: PMC8249992 DOI: 10.1002/jbmr.4304] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 03/30/2021] [Indexed: 02/06/2023]
Abstract
The development of coronavirus disease 2019 (COVID-19) vaccines has proceeded at an unprecedented pace, with numerous trials conducted simultaneously across the world as a result of massive technological and financial resource expenditures. With multiple vaccines having now received regulatory approval, public health efforts to promote widespread vaccine dissemination are currently underway. There has been particular emphasis placed on vaccination of older populations, the age group in which COVID-19 infection has been most lethal. However, such widespread vaccination approaches have necessarily raised important questions related to potential interactions with underlying diseases and concomitant treatments among persons to be vaccinated. Osteoporosis is a chronic condition marked by reduced bone strength and an associated increased risk for fracture that generally requires sustained medical intervention(s). Osteoporosis is neither associated with a higher risk of COVID-19 infection nor by more pronounced disease severity following infection, such that individuals with osteoporosis need not be more highly prioritized for COVID-19 vaccination. Osteoporosis therapies do not interfere with the efficacy or side effect profiles of COVID-19 vaccines and should not be stopped or indefinitely delayed because of vaccination. Depending on the specific drug profile within an anti-osteoporosis medication category, minor adjustments to the timing of drug administration may be considered with respect to the patient's COVID-19 vaccination schedule. Herein we provide practical recommendations for the care of patients requiring treatment for osteoporosis in the setting of COVID-19 vaccination. © 2021 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Elena Tsourdi
- Department of Medicine III, Universitätsklinikum Dresden, Dresden, Germany.,Center for Healthy Aging, Universitätsklinikum Dresden, Dresden, Germany
| | - Elaine W Yu
- Endocrine Unit, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Suzanne M Jan de Beur
- Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Matthew T Drake
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA.,Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, USA
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Andreozzi V, Marzilli F, Muselli M, Previ L, Cantagalli MR, Princi G, Guzzini M, Ferretti A. The Effect of Shelter-In-Place on Orthopedic Trauma Volumes in Italy During the COVID-19 Pandemic. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021216. [PMID: 33988156 PMCID: PMC8182575 DOI: 10.23750/abm.v92i2.10827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 01/24/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND The COVID-19 outbreak heavily attacked Italy, putting a strain for an extended time on the National healthcare system. Hospitals fastly rearranged the activity to cope with the crisis. This retrospective comparative study intended to investigate the impact of the lockdown imposed in Italy, in two different periods, during the COVID-19 outbreak on acute orthopedic trauma, in order to identify significant issues for improvement and future preparation. MATERIALS AND METHODS We obtained data on total trauma access to a single University hospital DEA (Department of Emergency and Acceptance) in Rome during two periods of the COVID-19 pandemic lockdown in Italy: from March 9th, 2020 to May 4th, 2020(Phase 1), from May 10th, 2020 to June 30th, 2020(Phase 2) and then comparing them with the analogous period in 2019. We recorded demographic data; the characteristics of the lesion, including the anatomical area, fracture, sprain, dislocation, contusion, laceration, whether the lesion site was exposed or closed, where the trauma occurred and polytrauma. We also reported the waiting time in the emergency room and the mode of transport. RESULT The study sample was composed of 1655 patients, 894 (54%) males and 761 (46%) females. The overall number of admissions in 2019 (pre-COVID-19 period) was 995; then it was 204 during Phase 1 and increased again to 456 during Phase 2. The average age of the Phase 1 group was 51.9 ± 24.8 years, significantly higher than that of the 2019 group (41.4 ± 25.7) and Phase 2 group (42.2 ± 22.5 years) (p<0.0001). In particular, elderly patients (>=65 years) were the most commonly involved in the Phase 1 group, while in the pre-COVID-19 period and in Phase 2 they were middle-aged adults (15-44 years) (p<0.0001). The injury occurred at home in 66.2% of cases in the Phase 1 group, in 32.3% of cases in the Phase 2 group and in 32.3% of patients in the 2019 group. Concerning the injury type, in all groups, the most frequent injury was a fracture (45.1% in 2019; 62.7% in Phase 1; 50% Phase2) (p<0.0001). The most injured anatomical section during Phase 1 was the upper limb (43.1%), while in the pre-COVID-19 group and in Phase 2 group the most frequent injury location was the lower limb (48.3% and 40.8% respectively). CONCLUSION Despite the decrease of overall acute trauma referral rates during the COVID-19 outbreak in Italy, the incidence of fractures in elderly people remained constant, indicating that not all trauma presentations would inevitably decrease during such circumstances.
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Affiliation(s)
- Valerio Andreozzi
- Department of Trauma and Orthopaedics, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
| | - Fabio Marzilli
- Department of Trauma and Orthopaedics, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
| | - Mario Muselli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Leonardo Previ
- 1Department of Trauma and Orthopaedics, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
| | - Matteo Romano Cantagalli
- 1Department of Trauma and Orthopaedics, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
| | - Giorgio Princi
- Department of Trauma and Orthopaedics, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
| | - Matteo Guzzini
- Department of Trauma and Orthopaedics, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
| | - Andrea Ferretti
- Department of Trauma and Orthopaedics, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
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Kalem M, Kocaoğlu H, Merter A, Karaca MO, Özbek EA, Kınık HH. Effects of COVID-19 pandemic curfew on orthopedic trauma in a tertiary care hospital in Turkey. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2021; 55:191-195. [PMID: 34100357 PMCID: PMC10566346 DOI: 10.5152/j.aott.2021.20263] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 08/26/2020] [Accepted: 10/06/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This study aimed to investigate whether various curfew practices affect trauma prevalence, epidemiological differences among the population admitted to hospital because of trauma, and treatment practices used after trauma. METHODS Patients who suffered from fractures or soft-tissue trauma between March 21, 2020, and June 1, 2020, (group pandemic) and during the same period in 2019 (control group) were included in our single-center retrospective study. Each group was also divided into 3 subgroups according to the age of patients (≤ 20 years, 21-64 years, and ≥ 65 years). Data including anatomical region subjected to trauma, place of admission, mechanism of trauma, location of trauma, mode of treatment, type of surgery (if performed), duration of hospitalization (if hospitalized), time elapsed until surgery, and duration of postoperative hospitalization were collected and compared between groups. RESULTS A total of 361 patients were admitted to the hospital with new trauma during the pandemic, and 708 patients had been admitted during the same period in 2019. The number of admissions decreased significantly by 50.9% (P < 0.001). The mechanism of trauma that occurred with low energy was significantly increased in the pandemic group (73.9%) compared with the control group (47.6%) (P < 0.001). Similarly, the distribution of trauma throughout the skeletal system, especially in the upper extremity, was significantly increased in the pandemic group (49.9% vs. 30.5%, P < 0.001). However, there was no significant decrease in individuals aged above 65 years (P = 0.115). Similar to the general outlook, the 3 groups differed in terms of the mechanism of trauma, location of trauma, and distribution of the anatomical region subjected to trauma (P < 0.001). Majority of the patients received inpatient treatment in all 3 groups (P < 0.001). CONCLUSION The results of this study showed that the pandemic dramatically reduced the number of hospital admissions related to orthopedic trauma. The rate of low energy, upper extremity traumas that occurred indoors increased during the pandemic period compared with that of the previous year. However, the rate of hospital admissions did not differ in the ≥65-year-old subgroup during the pandemic period compared with that of the previous year.
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Affiliation(s)
- Mahmut Kalem
- Department of Orthopedics and Traumatology, İbn'i Sina Training and Research Hospital, Ankara University, School of Medicine, Ankara, Turkey
| | - Hakan Kocaoğlu
- Department of Orthopedics and Traumatology, İbn'i Sina Training and Research Hospital, Ankara University, School of Medicine, Ankara, Turkey
| | - Abdullah Merter
- Department of Orthopedics and Traumatology, İbn'i Sina Training and Research Hospital, Ankara University, School of Medicine, Ankara, Turkey
| | - Mustafa Onur Karaca
- Department of Orthopedics and Traumatology, İbn'i Sina Training and Research Hospital, Ankara University, School of Medicine, Ankara, Turkey
| | - Emre Anıl Özbek
- Department of Orthopedics and Traumatology, İbn'i Sina Training and Research Hospital, Ankara University, School of Medicine, Ankara, Turkey
| | - Hüseyin Hakan Kınık
- Department of Orthopedics and Traumatology, İbn'i Sina Training and Research Hospital, Ankara University, School of Medicine, Ankara, Turkey
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Zhou Y, Ming J, Liu S. Epidemiologic characteristics and double-buffered strategy for patients in orthopedic surgery during the novel coronavirus outbreak: Wuhan's experience. Eur J Med Res 2021; 26:39. [PMID: 33931102 PMCID: PMC8085651 DOI: 10.1186/s40001-021-00510-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 04/22/2021] [Indexed: 01/08/2023] Open
Abstract
Background The purpose of this article is to summarize the epidemiologic characteristics and double-buffered strategy for patients in orthopedic surgery during the COVID-19 outbreak in Wuhan, China, based on our own experience in our hospital. Methods A retrospective and comparative study was performed to identify all inpatients at our clinic from February 17 to April 20, 2020 (epidemic group), and from February 17 to April 20, 2019 (control group). Epidemiologic characteristics, screening effect, perioperative complications, and nosocomial infection were analyzed. Results In the epidemic group, 82 patients were identified, a decrease by 76.0% than the 342 patients in the same period in the 2019. Patients in the epidemic group (54.6 ± 20.2 years) were older than those in the control group (49.6 ± 22.5 years). For the epidemic group, the proportion rates of traumatic factures (69.5%) and low-energy injuries (86.0%) were higher than that in the control group, respectively (35.4% and 37.2%). The preoperative waiting time (7.0 ± 2.6 days) in the epidemic group was longer than that in the control group (4.5 ± 2.1 days). The postoperative complication rate (12.2%) in the epidemic group was higher than that in the control group (3.5%). No nosocomial infection of orthopedic staff and patients with COVID-19 was noted in the epidemic group. Conclusion During the COVID-19 outbreak in Wuhan, China, orthopedic inpatients showed unique epidemiological characteristics. The double-buffered strategy could effectively avoid nosocomial infections among medical staff and patients. Doctors should fully evaluate the perioperative risks and complications.
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Affiliation(s)
- Yan Zhou
- Department of Orthopedics, Renmin Hospital of Wuhan University, #238 Jiefang Road, Wuhan, 430060, Hubei, People's Republic of China
| | - Jianghua Ming
- Department of Orthopedics, Renmin Hospital of Wuhan University, #238 Jiefang Road, Wuhan, 430060, Hubei, People's Republic of China
| | - Shiqing Liu
- Department of Orthopedics, Renmin Hospital of Wuhan University, #238 Jiefang Road, Wuhan, 430060, Hubei, People's Republic of China.
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